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- 束村 道雄
- 国立療養所中部病院内科
書誌事項
- タイトル別名
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- Relationship between roentgenographic feature and clinical course of lung disease due to Mycobacterium avium complex.
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抄録
Previously, Tsukamura observed that M. avium complex can cause infection in thecavity of lung tuberculosis, from which tubercle bacilli disappeared (Tsukamura, M.: Am.Rev. Respir. Dis., 108: 679, 1973; Kekkaku, 54: 71, 1979; Kekkaku, 55 215, 1980). Theroentgenographic feature of these cases was cavity in sclerotic lesion and therefore couldnot be differentiated from tuberculosis cavity. Based on this finding, he classified theroentgenographic feature of lung disease due to M. avium complex into two types: Primaryinfection-type, which shows solitary cavity or cavities with infiltrative process that does notshow any tendency of sclerotic process and has not history of tuberculosis; secondaryinfection-type, which shows cavities in sclerotic lesion and has the history of tuberculosis (Tsukamura, M.: Kekkaku, 50: 17, 1975; Kekkaku, 56: 23, 1981). In the present study, the relationship between the type of disease and the prognosis of disease was studied.<BR>A total of 168 patients with lung disease due to M. avium complex who werehospitalized in this hospital were the subjects of study. Of these, 118 belonged to theprimary infection-type, and the remaining 50 to the secondary infection-type. Of these168, 21 patients died in this hospital in an observation period of 20 years. Of these 21, 11were patients with the first type and 8 of them died due to respiratory failure causedby progress of lung disease due to M. avium complex itself, whereas only one patient withthe second type died due to such respiratory failure. Five of the second type died due toother diseases. The relationship between the type of disease and the prognosis wasobserved in 110 patients who were hospitalized for more than one year. Of these 110, 77belonged to the primary infection-type and 33 belonged to the secondary infection-type.Of patients who had the primary infection, 18 (23%) achieved the closure of cavity andthe negative conversion of sputum culture and 31 (40%) had the negative conversion withoutclosure of cavity. In contrast, of 33 patients with the secondary infection, only 5 (15%) had the negative conversion without closure of cavity. From the above observations, ithas been considered that, in patients with primary infection, the healing and the negative conversion often occur but, on the other hand, the deterioration also often occurs, and that, in patients with secondary infection, the negative conversion can occur only rarely but thedeterioration or progress of disease is rare.
収録刊行物
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- 結核
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結核 61 (11), 567-571, 1986
一般社団法人 日本結核病学会
