양어장 근무자에서 Mycobacterium terrae에 의해 발생한 과민성폐렴 1예
A Case of Hypersensitivity Pneumonitis Caused by Mycobacterium terrae in a Fishery Worker
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초록
NTM에 의한 과민성 폐렴은 주로 MAC에 오염된 온수에 노출된 후 폐에 감염 또는 과민반응에 의해 발생하는 폐질환으로 알려져 있다. 저자들은 양어장에서 근무하던 중 호흡곤란, 기침, 가래 등의 증상으로 내원한 54세 남자 환자의 객담과 양어장 물에서 Mycobacterium terrae가 동정되었던 과민성 폐렴 1예를 경험하여 보고하는 바이다. 흉부 전산화단층촬영에서 다발성 공기포획을 동반한 미만성 간유리 음영과 중심소엽성 결절들이 관찰되었고, 경기관지폐생검상 폐실질에 육아종성 염증 소견을 보였다. 환자는 코르티코스테로이드 투여 후 증상 및 방사선 소견의 호전을 보였다.
Abstract
Hypersensitivity pneumonitis caused by exposure to non-tuberculous mycobacteria in indoor hot tubs has been called “hot tub lung.” Most of these cases of hypersensitivity pneumonitis were, in fact, caused by Mycobacterium avium complex. We describe a case of hypersensitivity pneumonitis caused by M. terrae. A 54-year-old man presented with a 4-month history of exertional dyspnea, cough, and sputum. The patient had been working in a fishery for 5 years. Approximately 3 months before the onset of symptoms, he began working at another fishery. His chest CT scans showed diffuse ground-glass opacities with multifocal air trappings and centrilobular nodules in both lungs. Transbronchial lung biopsy specimens revealed hypersensitivity pneumonitis. M. terrae was isolated from a mycobacterial culture of his sputum and the water at the fishery. (Korean J Med 2011;80:S204-S208)
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