[Clinical comparison of pulmonary tuberculosis with pulmonary M. avium complex disease]

At first, we reviewed radiographic findings of primary pulmonary tuberculosis, secondary pulmonary tuberculosis, pulmonary M. avium complex (MAC) disease without predisposing conditions, and pulmonary tuberculosis in AIDS patient. Infiltrates in lower field, mediastinal lymphadenopathy, and pleural effusion were the characteristics for primary pulmonary tuberculosis, while multiple nodular shadow with/without cavitation in S1,2,6 were the characteristics for secondary pulmonary tuberculosis. In pulmonary MAC disease without predisposing conditions, lesions progressed slowly from a cluster of a small nodules to cystic bronchiectasis with collapse of the segment or the lobe, and it took usually more than 10-years for the whole process interval. The characteristics of pulmonary tuberculosis in AIDS patient were nearly the same as those of primary pulmonary tuberculosis. Secondly, we compared clinical characteristics between pulmonary tuberculosis and pulmonary MAC disease. We reviewed the medical records of hospitalized patients who were diagnosed as pulmonary tuberculosis or pulmonary MAC disease. Systemic compromised host defense, such as diabetes mellitus or malignancy, played a more important predisposing factors in the development of pulmonary MAC disease. The average age of patients with MAC disease was found to be older than those with tuberculosis. By gender women were predominant in MAC disease, while men were predominant in tuberculosis.