Case Presentation

AOID Case Presentation

1. A Previously Healthy Female in her 40s with Multiple Bone and Soft Tissue Lesions Presenting with Back Pain
2. A Female Patient in her 70s Reported Recurrence After Completion of Antibacterial Chemotherapy with MAC Detected in Bone Marrow Cultures
3. A Male Patient in his 60s in whom NTM Disease was Difficult to Diagnose with Imaging, Pathology, and Culture Tests

1. A Previously Healthy Female in her 40s with Multiple Bone and Soft Tissue Lesions Presenting with Back Pain（PMID: 19396523）

• Lesions were detected in the femur, sternum, spine, ilium, and multiple soft tissue masses.
• Bone biopsy revealed granulomatous lesions with acid-fast bacilli and multinucleated giant cells. Mycobacterium avium complex (MAC) was detected in cultures.
• It took around 6 months from the initial symptoms to diagnosis.
• Antibacterial chemotherapy alone did not lead to improvement, requiring surgical drainage.

2.A Female Patient in her 70s Reported Recurrence After Completion of Antibacterial Chemotherapy with MAC Detected in Bone Marrow Cultures（PMID: 25653414）

• Mycobacterium avium complex (MAC) was detected in the lungs with pleural effusion, liver, and bone marrow, leading to a diagnosis of disseminated nontuberculous mycobacterial (NTM) infection.
• There was a gradual increase in fever and malaise after completing 2 years of antibacterial chemotherapy.
• MAC was detected again only in the bone marrow.

3.A Male Patient in his 60s in whom NTM Disease was Difficult to Diagnose with Imaging, Pathology, and Culture Tests（PMID: 25735882）

• The patient presented with cervical lymphadenopathy and an intratracheal polypoid lesion.
• No pathological findings suggesting malignancy or mycobacterial infection were obtained, and acid-fast bacilli smears were negative.
• Mycobacterium gordonae was detected only from the cervical lymph node, initially considered as a contamination.
• Reassessment after deterioration led to a diagnosis of disseminated NTM.