Two Cases of Nontuberculous Mycobacterial Lung Disease in Heart Transplant Recipients.

Jo, Jung Min; Shin, Mi Seon; Kim, Joo Hui; Kim, Min Jung; Park, Hyun Jung; Na, Hee Kyung; Jo, Kyung Uk; Kim, Jae Joong; Shim, Tae Sun

doi:2010.69.3.201

Tuberc Respir Dis > Volume 69(3); 2010 > Article

Case Report

Tuberculosis and Respiratory Diseases 2010;69(3):201-206.
DOI: https://doi.org/10.4046/trd.2010.69.3.201 Published online September 1, 2010.

Two Cases of Nontuberculous Mycobacterial Lung Disease in Heart Transplant Recipients.

Jung Min Jo, Mi Seon Shin, Joo Hui Kim, Min Jung Kim, Hyun Jung Park, Hee Kyung Na, Kyung Uk Jo, Jae Joong Kim, Tae Sun Shim

¹Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
²Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. shimts@amc.seoul.kr
³Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

Nontuberculous mycobacterial (NTM) diseases are increasing worldwide. However NTM lung disease in organ transplant recipients has been rarely reported. Here, we report 2 cases of NTM lung disease in heart transplant recipients. A 37-year-old man, who had undergone a heart transplant one year previous, was admitted to hospital due to a cough. Chest CT scan showed multiple centrilobular nodules in both lower lungs. In his sputum, M. abscessus was repeatedly identified by rpoB gene analysis. The patient improved after treatment with clarithromycin, imipenem, and amikacin. An additional patient, a 53-year-old woman who had undergone a heart transplant 4 years prior and who suffered from bronchiectasis, was admitted because of purulent sputum. The patient's chest CT scan revealed aggravated bronchiectasis; M. intracellulare was isolated repeatedly in her sputum. Treatment was successfully completed with clarithromycin, ethambutol, and ciprofloxacin. NTM lung disease should be considered as a potential opportunistic infection in organ transplant recipients.

Key Words: Mycobacteria, Atypical, Heart Transplantation, Lung Diseases