Cavitary Pulmonary Nontuberculous Mycobacterium Infection in an Adult Patient with Cyanotic Congenital Heart Disease

Pediatric Cardiology and Cardiac Surgery
Vol.25 No.1 2009 (56-60)

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Yoshiaki Kato,¹⁾ Hitoshi Horigome,¹⁾ Miho Takahashi-Igari,¹⁾ Chiho Tokunaga,²⁾ Yuji Hiramatsu,²⁾ Hidetaka Nishina,³⁾ and and Yasunori Funayama⁴⁾

Departments of ¹⁾Pediatrics, ²⁾Cardiovascular Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, ³⁾Department of Cardiology, Tsukuba Medical Center Hospital, and ⁴⁾Department of Pulmonary Medicine, Tsukuba Gakuen Hospital, Tsukuba, Japan

Abstract

We report a 23-year-old man with cyanotic congenital heart disease complicated by cavitary pulmonary nontuberculous mycobacterium (NTM) infection. The heart defect consisted of dextrocardia in situs solitus, double-outlet right ventricle, pulmonary stenosis, hypoplastic left ventricle, mitral atresia and atrial septal defect. The patient had undergone bidirectional Glenn anastomosis and had had cough and low-grade fever for the last few months. Cavitary lesions in the left upper lung lobe, which had not been found on previous chest X-ray films, were clearly demonstrated by computed tomography (CT). Mycobacterium detected from the patient’s sputum was identified as Mycobacterium kansasii (M. kansasii). Cough and low-grade fever disappeared after oral administration of antibiotics. The number of patients with NTM is increasing worldwide these days, and the clinical features of NTM infection, especially by M. kansasii, resemble tuberculosis. As patients with cyanotic congenital heart disease are possibly at high risk not only of pulmonary tuberculosis but also NTM infection, CT of the chest and identification of organisms using the polymerase chain reaction (PCR) technique are needed without delay when cough, sputum, or low-grade fever persist.