1977 Volume 52 Issue 12 Pages 645-651
A 19 years old male, student, whose symptoms occurred acutely with high fever and nonproductive cough.
Chest roentogenogram revealed extensive diffuse infiltration in the whole field of right lung. Pneumonia was suspected and treatment with antibiotics was started. No sign of improvement was observed. Night sweating, emaciation and hypertrophic osteoarthropathy appeared after one and a half month from the onset. Sputa culture was negative. Various antibiotics were administered, but no effect was observed, and high fever continued.
Three months later, multiple cavities appeared in the infiltrated lesion. Staphylococcal pneumonia was suspected, and KM and Staphcillin were administered. Six months later, gastric juice culture revealed 1-2 colonies of acid-fast bacilli. Drugs were changed to KM·INH·EEB. Chest roentogenogram revealed increased cavitary lesions and cystic or bullous lesions. Eight months later, the patient was operated due to pneumothorax in the right side. With the findings at operation all of the signs described above were regarded to be attributable to tuberculosis macroscopically and microscopically. In conclusion, the case is so called “lower lung field tuberculosis”.
