Two cases of Mycobacterium intracellulare infection of the lung in association with bronchiectasis were reported.
Case one is a 47-year-old housewife whose chest x-ray film revealed confined infiltrate in the middle lobe with marked elevation of the anterior diaphragma neighbouring the lesion, and M. intracellulare was isolated from the bronchofiberscope aspirate initially and then from sputa repeatedly. The bronchogram showed restricted bronchiectasis of the proxymal bronchus of middle lobe with normal bronchioles distal to the ectatic part, which was suspected to be a result of the primary infection. Inspite of the drugs resistance, patient was cured after nine months of treatment with SM, INH and RFP.
Case two is a 73-year-old woman who has been diagnosed aortic valvular stenosis since the age of fifty, showing linear with fibrotic radiolucence extending from hilum to the posterior lower lung field typically seen inbronchiectasis-associated with a little infiltration revealed by chest x-ray film, and M. intracellulare was repeatedly isolated from the sputum. The bronchogram revealed cylindrical bronchiectasis with moderate reduction of the lower lobe volume, which was suspected to be a type of superinfection to the preexsisting bronchiectasis. Because of severe dizziness induced as side-effect of antituberculous chemotherapy administrated from previous doctor, the patient is now being treated symptomatically without any aggrevation for about a year.
The difficulty in diagnosing these presented cases based on chest x-ray findings such as lack of cavitation, unusual location of lesions and bronchiectasis revealed bybronchogram-which are rarely seen in ordinary cases of pulmonary atypical mycobacteriosis is stressed.
