Multiple, severe lung infiltrates due to Mycobacterium avium-intracellulare in a patient with decompensated liver cirrhosis: Spontaneous resolution after a two-year follow-up.

Abstract

A unique case of severe, multiple, microbiologically-confirmed pulmonary Mycobacterium avium-intracellulare lesions occurred in a female with decompensated liver cirrhosis, and went to cure after around 2 y despite the impossibility to deliver an effective antimicrobial chemotherapy, owing to the patient's intolerance. From an extensive literature review, we underline a possible mechanism prompting mycobacterial disease during advanced liver disease, while we retrieved only 2 described cases of possible spontaneous resolution of Mycobacterium terrae lung disease, although both were reported in patients without end-organ liver disease, who received a specific combined chemotherapy for an appreciable time period. On the other hand, while decompensated liver cirrhosis is more frequently complicated by a peritoneal localization of bacteria and very infrequently mycobacteria, the reported case represents the first severe pulmonary localization of multiple lesions due to Mycobacterium avium-intracellulare. Moreover, this extraordinary episode resolved spontaneously within the 2-y follow-up, as documented by bronchoalveolar lavage, culture, high-resolution CT scans, and scintigraphic examination.

• Authors: Roberto Manfredi, Sergio Sabbatani, Luciano Attard, Francesco Chiodo
• Journal: Scandinavian journal of infectious diseases (Scand J Infect Dis) Vol. 38 Issue 6-7 Pg. 469-73 ( 2006) ISSN: 0036-5548 [Print] England
• PMID: 16798696 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Antitubercular Agents

Topics

• Aged
• Antitubercular Agents (adverse effects)
• Drug Therapy, Combination
• Female
• Humans
• Liver Cirrhosis (complications)
• Lung Diseases (drug therapy, microbiology)
• Mycobacterium avium-intracellulare Infection (drug therapy, microbiology)
• Remission, Spontaneous