Serial CT Findings of Mycobacterium massiliense Pulmonary Disease Compared with Mycobacterium abscessus Disease after Treatment with Antibiotic Therapy

Published Online:https://doi.org/10.1148/radiol.12111374

Most patients with Mycobacterium massiliense pulmonary disease have improvement in the CT findings and all patients demonstrate negative sputum conversion during antibiotic treatment.

Purpose

To present the serial computed tomographic (CT) findings of lung abnormalities in Mycobacterium massiliense pulmonary disease compared with those in Mycobacterium abscessus disease.

Materials and Methods

The institutional review board approved this retrospective study and waived informed consent. Serial chest CT scans of M massiliense (n = 34) and M abscessus (n = 24) pulmonary diseases were retrospectively reviewed. Patients were treated with clarithromycin-containing combination antibiotics regimen, and sputum examinations were performed regularly. CT scans were obtained at the beginning of antibiotic therapy, at the end of 4-week hospitalization, and at the time of 12-month antibiotic therapy.

Results

All patients with M massiliense disease had sputum conversion during treatment, whereas 50% of patients with M abscessus disease had sputum conversion. The most common CT findings of M massiliense disease at presentation were cellular bronchiolitis (n = 34, 100%), bronchiectasis (n = 34, 100%), consolidation (n = 33, 97%), nodules (n = 32, 94%), and cavities (n = 15, 44%). These findings were similar in M abscessus disease. Thirty (88%) patients with M massiliense disease had decrease in overall CT score at 12-month therapy, whereas only eight (33%) patients with M abscessus disease had a decrease (P < .0001). Improvement was noticeable in cellular bronchiolitis and cavity in M massiliense disease.

Conclusion

Common CT findings of M massiliense diseases overlap with those of M abscessus disease. However, responses to antibiotic treatment are much different; in M massiliense disease, negative sputum conversion is accomplished in all patients and serial CT scans show improvement in most patients.

© RSNA, 2012

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Article History

Received July 13, 2011; revision requested August 22; revision received September 26; accepted November 2; final version accepted November 14.
Published online: Apr 2012
Published in print: Apr 2012