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Jo, Shin, Kim, Kim, Park, Na, Jo, Kim, and Shim: Two Cases of Nontuberculous Mycobacterial Lung Disease in Heart Transplant Recipients
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2010; 69(3): 201-206.

Published online: 30 September 2010

DOI: https://doi.org/10.4046/trd.2010.69.3.201

Two Cases of Nontuberculous Mycobacterial Lung Disease in Heart Transplant Recipients

Jung Min Jo, M.D.1, Mi Seon Shin, M.D.1, Joo Hui Kim, M.D.1, Min Jung Kim, M.D.1, Hyun Jung Park, M.D.1, Hee Kyung Na, M.D.1, Kyung Uk Jo, M.D.2, Jae-Joong Kim, M.D.3, Tae Sun Shim, M.D.2

1Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

2Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

3Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Address for correspondence: Tae Sun Shim, M.D. Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap 2-dong, Songpa-gu, Seoul 138-736, Korea. Phone: 82-2-3010-3892, Fax: 82-2-3010-6968, shimts@amc.seoul.kr

Received 16 March 2010       Accepted 21 April 2010

Copyright © 2010. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Nontuberculous mycobacterial (NTM) diseases are increasing worldwide. However NTM lung disease in organ transplant recipients has been rarely reported. Here, we report 2 cases of NTM lung disease in heart transplant recipients. A 37-year-old man, who had undergone a heart transplant one year previous, was admitted to hospital due to a cough. Chest CT scan showed multiple centrilobular nodules in both lower lungs. In his sputum, M. abscessus was repeatedly identified by rpoB gene analysis. The patient improved after treatment with clarithromycin, imipenem, and amikacin. An additional patient, a 53-year-old woman who had undergone a heart transplant 4 years prior and who suffered from bronchiectasis, was admitted because of purulent sputum. The patient's chest CT scan revealed aggravated bronchiectasis; M. intracellulare was isolated repeatedly in her sputum. Treatment was successfully completed with clarithromycin, ethambutol, and ciprofloxacin. NTM lung disease should be considered as a potential opportunistic infection in organ transplant recipients.

Keywords: Mycobacteria, Atypical, Heart Transplantation, Lung Diseases

Figures and Tables

Figure 1
HRCT scan showed multiple centrilobular nodules with branching linear opacity and bronchiectasis predominantly in both lower lobes (A, B). After treatment for M. abscessus, the lesions were resolved (C, D).
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Figure 2
On OMU CT scan, severe sinusitis and polyposis were seen in both maxillary and ethmoid sinuses.
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Figure 3
Chest CT scan showed bronchiectasis and combined bronchopneumonia in the right middle lobe (A) and left lower lobe (B). Those were improved after treatment with clarithromycin and ethambutol (C, D).
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