左荒蕪肺を呈した多剤耐性肺結核に左肺全摘術を施行した1例  [in Japanese] A CASE OF PULMONARY MULTI-DRUG RESISTANT TUBERCULOSIS WITH LEFT DESTROYED LUNG, TREATED WITH PNEUMONECTOMY  [in Japanese]

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Author(s)

    • 小山 和彦 KOYAMA Kazuhiko
    • 独立行政法人国立病院機構長崎神経医療センター呼吸器科 Department of Pulmonary Medicine, National Hospital Organization (NHO) Nagasaki Medical Center of Neurology
    • 川上 健司 KAWAKAMI Kenji
    • 独立行政法人国立病院機構長崎神経医療センター呼吸器科 Department of Pulmonary Medicine, National Hospital Organization (NHO) Nagasaki Medical Center of Neurology
    • 原田 義高 [他] HARADA Yoshitaka
    • 独立行政法人国立病院機構長崎神経医療センター呼吸器科 Department of Pulmonary Medicine, National Hospital Organization (NHO) Nagasaki Medical Center of Neurology
    • 山領 豪 YAMARYO Takeshi
    • 独立行政法人国立病院機構長崎神経医療センター呼吸器科 Department of Pulmonary Medicine, National Hospital Organization (NHO) Nagasaki Medical Center of Neurology
    • 木村 由美子 KIMURA Yumiko
    • 独立行政法人国立病院機構長崎神経医療センター臨床検査科 Department of Clinical Laboratory, National Hospital Organization (NHO) Nagasaki Medical Center of Neurology

Abstract

症例は31歳女性。2003年10月から咳嗽,発熱で発症し,2004年1月に肺結核の診断が確定した。INH,RFP,EB,PZAによる標準治療を開始したが,同年3月には薬剤感受性試験の結果から多剤耐性肺結核と診断した。その後PZA,TH,CS,EVM,LVFXにて治療を行ったが排菌が持続した。2004年8月下旬に左荒蕪肺に対して左肺全摘術を施行し,術後は排菌が陰性化した。化学療法のみでの治療が困難な多剤耐性肺結核に対し外科療法が有効であった。

A 31-year-old woman complained of cough and fever for 2 months. She was admitted to a hospital and was diagnosed as pulmonary tuberculosis. She received combination therapy with isoniazid, rifampicin, ethambutol, and pyrazinamide. As the drug susceptibility test revealed that the isolated strain was multi-drug resistant, the regimen was changed to pyrazinamide, ethionamide, cycloserine, enviomycin, and levofloxacin. The chemotherapy was not effective, so she received pneumonectomy for left destroyed lung. After surgical treatment, her sputa converted to negative for tubercle bacilli. Surgical treatment such as pneumonectomy is considered to be useful in a case of multi-drug resistant pulmonary tuberculosis.

Journal

  • Kekkaku(Tuberculosis)

    Kekkaku(Tuberculosis) 82(7), 577-581, 2007-07-15

    JAPANESE SOCIETY FOR TUBERCULOSIS

References:  15

Codes

  • NII Article ID (NAID)
    10019827586
  • NII NACSIS-CAT ID (NCID)
    AN00073442
  • Text Lang
    JPN
  • Article Type
    NOT
  • ISSN
    00229776
  • NDL Article ID
    8895432
  • NDL Source Classification
    ZS21(科学技術--医学--内科学)
  • NDL Call No.
    Z19-133
  • Data Source
    CJP  NDL  J-STAGE 
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