LONG-TERM FOLLOW-UP OF PULMONARY-DISEASE CAUSED BY MYCOBACTERIUM-AVIUM IN A PREVIOUSLY HEALTHY PATIENT

A 64-year-old white male with cavitary lung disease is presented. Myco bacterium avium was isolated from sputa and gastric lavage and the Ame rican Thoracic Society criteria for nontuberculous mycobacterial disea se were met. Seven years follow-up and treatment regimens are discusse d. This case illustrates that medical treatment of M. avium pulmonary disease can be disappointing and requires regular clinical, radiologic al, microbiological and haematological reassessment to evaluate effica cy and toxicity of therapy.Despite in vitro resistance to the standard antimycobacterial agents, prolonged treatment regimens can be success ful and are the therapy of choice. Another drug combination, based on in vitro susceptibility patterns, has to be started for patients who f ail to respond or who relapse. Lifelong treatment may be necessary to keep the patient stable and to prevent further destruction of lung par enchyma.