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Lee, Park, Kim, Choi, Kim, Chung, Yoo, Choi, Kim, Lee, and Kim: A Case of Mycobacterium szulgai Lung Disease in Patient with Healed Tuberculosis
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2012; 72(1): 55-58.

Published online: 30 January 2012

DOI: https://doi.org/10.4046/trd.2012.72.1.55

A Case of Mycobacterium szulgai Lung Disease in Patient with Healed Tuberculosis

Eun Jung Lee, M.D.1, Ji Young Park, M.D.1, Eun Young Kim, M.D.1, Jaeho Choi, M.D.1, Hyun Soo Kim, M.D.1, Sang Wan Chung, M.D.1, Jee-Hong Yoo, M.D., Ph.D.1, Cheon Woong Choi, M.D., Ph.D.1, Gou Young Kim, M.D., Ph.D.2, Jong Hoo Lee, M.D.3, Yee Hyung Kim, M.D.1

1Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.

2Department of Pathology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.

3Department of Pulmonary and Critical Care Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.

Address for correspondence: Yee Hyung Kim, M.D. Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 149, Sangil-dong, Gangdong-gu, Seoul 134-727, Korea. Phone: 82-2-440-8149, Fax: 82-2-440-8150, kumc92@naver.com

Received 22 July 2011       Revised 29 July 2011       Accepted 19 August 2011

Copyright © 2012. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Mycobacterium szulgai is a rare nontuberculous mycobacterium found in Korea. It is an opportunistic pathogen and is usually isolated from patients with a history of alcoholism, chronic pulmonary disease, or an immunocompromising condition. We present here a case of M. szulgai isolated from a patient with a history of pulmonary tuberculosis. A 54-year-old man was admitted with dyspnea and febrile sensation. He had a history of pulmonary tuberculosis which occurred 30 years earlier and treatment with anti-tuberculosis medication. His chest computed tomography scan showed cavitary consolidation in both upper lungs. A sputum acid-fast bacilli (AFB) smear was positive and anti-tuberculous medication was started. However, a polymerase chain reaction for mycobacterium tuberculosis was negative and anti-tuberculous medication was stopped. M. szulgai was isolated on 3 separate sputum and bronchial wash fluid AFB cultures. He was treated with clarithromycin, rifampicin, and ethambutol. After 1 month, a sputum AFB smear and culture became negative and no additional M. szulgai were isolated during a 16-month treatment.

Keywords: Nontuberculous Mycobacteria, Chronic Necrotizing Pulmonary Aspergillosis

Figures and Tables

Figure 1
The initial chest X-ray showing destroyed lung lesions. Multifocal cystic lesions and consolidations are also seen.
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Figure 2
The initial chest CT showing wall thickening of cavitary lesion in left upper lobe and peribronchial air space consolidation in right lung. CT: computed tomography.
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Figure 3
The follow-up chest X-ray after 16 months of treatment (treatment completion). Decreased extent of consolidation and cavitary lesion are seen.
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