Successful treatment of Mycobacterium abscessus pulmonary disease with limited resection and perioperative chemotherapy containing clofazimine: a case report

IF 0.7 Q4 RESPIRATORY SYSTEM

Respiratory Medicine Case Reports Pub Date : 2026-01-01 Epub Date: 2026-07-06 DOI:10.1016/j.rmcr.2026.102459

Takumi Yasuda, Hidenori Takahashi, Yugo Satake, Hiroki Nagamatsu, Ryutaro Hirose, Mio Toyama-Kosaka, Miwa Morikawa, Shinichiro Ota, Yasunari Kanno, Takashi Makino, Kohei Ando, Masaharu Shinkai

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Abstract

We report a case of localized Mycobacterium abscessus complex pulmonary disease with phenotypic inducible macrolide resistance in a previously healthy woman in her 40s. Chest computed tomography (CT) showed a solitary thin-walled cavitary nodule with perilesional centrilobular nodules, confined to the right upper lobe. Bronchial lavage culture grew M. abscessus subsp. abscessus/bolletii. Clarithromycin susceptibility shifted from susceptible on Day 3 to resistant on Day 14. Combination antimicrobial therapy was initiated with imipenem/cilastatin, amikacin, azithromycin, clofazimine, and sitafloxacin. This led to rapid radiologic improvement, and video-assisted thoracoscopic wedge resection was performed 24 days after initiation of antimicrobial therapy. Culture and PCR of the resected specimen were negative for pathogens. The patient completed a 12-month course of antimicrobial therapy and remains recurrence-free at 30 months based on CT follow-up. The only notable side effect of chemotherapy was grade 2 skin hyperpigmentation, which was attributed to clofazimine.

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有限切除和氯法齐明围手术期化疗成功治疗脓肿分枝杆菌肺病1例报告。

我们报告一例局部脓肿分枝杆菌复杂肺部疾病与表型诱导大环内酯耐药在一个以前健康的妇女在她的40。胸部计算机断层扫描（CT）显示一个孤立的薄壁腔性结节，病灶周围有小叶中心结节，局限于右上叶。支气管灌洗培养脓肿分枝杆菌。脓肿/ bolletii。克拉霉素敏感性在第3天由敏感转变为第14天耐药。联合抗菌治疗开始使用亚胺培南/西司他汀、阿米卡星、阿奇霉素、氯法齐明和西他沙星。这导致了放射学的快速改善，并在抗菌药物治疗开始24天后进行了视频辅助胸腔镜楔形切除术。切除标本的培养和PCR结果均为阴性。患者完成了12个月的抗菌药物治疗，在CT随访的30个月里没有复发。化疗唯一显著的副作用是2级皮肤色素沉着，这归因于氯法齐明。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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