Lymphangioleiomyomatosis Showing the Development of Mycobacterium abscessus subsp. massiliense Infection during Sirolimus Therapy

Intern Med. 2024 Jul 15;63(14):2043-2047. doi: 10.2169/internalmedicine.2847-23. Epub 2023 Nov 27.

Abstract

Among nontuberculous mycobacterial pulmonary diseases (NTM-PDs), Mycobacterium abscessus species pulmonary disease (MABS-PD) is one of the most severe and intractable infections. We herein report a 45-year-old woman with advanced lymphangioleiomyomatosis (LAM) who developed MABS-PD while undergoing sirolimus therapy. MABS-PD was immediately controlled using antibiotic therapy, although the patient's lung transplant registration was significantly delayed. To our knowledge, this is the first case report on the development of NTM-PD in a patient with LAM before lung transplantation. This case suggests that the early diagnosis and optimal treatment of NTM-PD are crucial in patients with advanced LAM.

Keywords: Mycobacterium abscessus species; lymphangioleiomyomatosis; nontuberculous mycobacterial pulmonary disease; sirolimus.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use
  • Female
  • Humans
  • Lung Transplantation / adverse effects
  • Lymphangioleiomyomatosis* / diagnosis
  • Lymphangioleiomyomatosis* / drug therapy
  • Middle Aged
  • Mycobacterium Infections, Nontuberculous* / diagnosis
  • Mycobacterium Infections, Nontuberculous* / drug therapy
  • Mycobacterium Infections, Nontuberculous* / etiology
  • Mycobacterium abscessus* / isolation & purification
  • Sirolimus* / adverse effects
  • Sirolimus* / therapeutic use

Substances

  • Sirolimus
  • Anti-Bacterial Agents