Nontuberculous Mycobacterial Lung Disease Accompanied by Organizing Pneumonia

Abstract

We herein report our experience with patients who had nontuberculous mycobacterial lung disease (NTM disease) accompanied by organizing pneumonia (OP). Out of 98 NTM disease patients who had undergone a biopsy or surgical resection, 11 patients had OP that was revealed histologically. After excluding six patients who had OP-related diseases (idiopathic interstitial pneumonia, rheumatoid arthritis, etc.), the remaining five patients were studied. Two of them (a 73-year-old man and a 66-year-old woman) showed common clinical feature: acute-onset symptoms of cough and fever, infiltrating shadows and dramatic improvement following treatment with a corticosteroid and anti-mycobacterial therapy. Our cases demonstrate that NTM disease is sometimes accompanied by OP histologically, and some such cases show common clinical features.

Successful treatment of acute respiratory failure in a patient with pulmonary Mycobacterium abscessus infection accompanied by organizing pneumonia

“…To the best of our knowledge, M. abscessus lung disease accompanying OP has not been described in the English language literature, with the exception of only one case diagnosed with bronchial washing and TBLB (6). Pulmonary M. abscessus infection can present different clinicopathological features according to the various immune responses of the host.…”

“…Pulmonary NTM disease is the most common type of involvement and occurs primarily in patients with preexisting structural lung damage such as emphysema or On the other hand, rare cases with different disease entities have been reported: NTM disease accompanied by histologically proven OP in which patients developed acute or subacute symptoms with infiltrates on chest images, and improved rapidly following treatment with a combination of a corticosteroid and anti-mycobacterial therapy (6,(8)(9)(10). Hamada et al (8) reported a 67-year-old woman with fever and dyspnea; her sputum culture confirmed Mycobacterium intracellulare, and transbronchial lung biopsy (TBLB) revealed OP that showed dramatic clinical improvement clinically with corticosteroid and anti-mycobacterial treatment (clarithromycin, rifampicin, and levofloxacin).…”

“…In these reports, the authors considered that OP was probably induced secondary to NTM disease or that OP was one of the clinicopathological features of NTM lung diseases. Nakahara et al (6) reported five patients with NTM lung disease and the coexistence of OP; four patients had M. avium infection and one patient had M. abscessus infection. These reports described NTM lung disease accompanied by OP that improved with corticosteroids and antimycobacterial treatment.…”

“…A number of viral and bacterial organisms, including herpes virus, coronavirus (especially severe acute respiratory syndrome coronavirus; SARS-CoV) infection, Mycoplasma pneumoniae, and Mycobacterium tuberculosis have been identified as infectious causes of OP (2)(3)(4)(5). However, Mycobacterium abscessus (M. abscessus) has rarely been reported as a causative factor of OP with acute respiratory failure (ARF) (6). Here, we report a woman diagnosed with ARF due to pulmonary M. abscessus infection with simultaneous presentation of OP.…”

Cryptogenic organizing pneumonia masquerading as lung carcinoma: A case report and review of the literature

“…A search of the literature was performed using Medline ( ) with the keywords ‘bronchiolitis obliterans organizing pneumonia OR cryptogenic organizing pneumonia AND lung cancer’ and ‘bronchiolitis obliterans organizing pneumonia OR cryptogenic organizing pneumonia AND case report’. Studies on secondary OP were excluded and a total of 23 studies ( 1 , 2 , 5 , 6 , 8 – 26 ) were retrieved by December 2015.…”