Nontuberculous Mycobacteriosis Research Articles

Anti-TB Drug-Induced Rush and Leukopenia: Implications for Management of TB-Experience in Japan

SESSION TITLE: Tuberculosis SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, November 1, 2017 at 01:30 PM - 02:30 PM PURPOSE: To investigate the incidence rates and risk factors of rush and leukopenia caused by anti-tuberculous chemotherapy. METHODS: All the patients with active tuberculosis and nontuberculous mycobacteriosis (NTM) , who were treated with anti-tuberculous chemotherapy in our hospital between March 2012 and June 2015. The definition of rush is as follows : rush emerging after induction of anti-tuberculous therapy and suspected to be induced by antituberculous drug. The definition of leukopenia is as follows: decreased white blood cell count (WBC), that is less than 3500/mm3 during chemotherapy, based on CTCAE ver4.0. 220 patients with tuberculosis (including 31 latent tuberculosis infection(LTBI) patients)and 180 patients with nontuberculous mycobacteriosis (including 180 Mycobacterium avium complex (MAC) patients) were analyzed for this study. 116 patients with tuberculosis were treated by isoniazid(INH),rifampicin(RFP),ethambutol(EB) and pyrazinamide(PZA)(HREZ) and 44 patients with tuberculosis were treated by INH,RFP and EB(HRE). 148 patients with MAC were treated by clarithromycin(CAM), RFP and EB(RE-CAM). We examined the incidence rates of rush and leukopenia in patients treated by HREZ, HRE and RE-CAM. Those patients were divided into the rush, non-rush groups and the leukopenia, non-leukopenia groups. We executed multivariate analysis for each factor (age, gender, weight, BMI, pre-treatment WBC, Alb, LDH, T-Bil, AST, ALT, Cre, and CRP, each regimen use). RESULTS: The incidence rates of rush of HREZ, HRE and RE-CAM were 41%, 31%, 33%.There were no significant difference among regimens and factors. The number of cases, in which the responsible drugs for rush was identified, were: 22 cases for EB, 3 cases for INH, 1 case for RFP, and 1 case for PZA. Rush did not require any treatment in 67 cases, although it did antihistaminic agents and external preparation of steroid in 25 cases and desensitization therapy in 16 cases. The incidence rates of leukopenia of HREZ, HRE and RE-CAM were 29%, 31% and 50%. There was a significant difference between RE-CAM and other regimens. (p value 0.02＜0.05). RE-CAM regimen and low WBC count before the treatment were likely to be the risk factors of leukopenia (RE-CAM regimen: Odds ratio 1.690, p value 0.053. low WBC count before the treatment : Odds ratio 0.999, p value 0.000). CONCLUSIONS: Since among HREZ, HRE and RE-CAM regimens including RFP and EB, there was no significant difference in the incidence rates of rash, INH and PZA might be thought to be less potent on emerging of rash. RFP and EB might be the responsible drugs for rash. In this study, EB was the most common drug that was identified. The most responsible drug for leukopenia might be RFP through the data above. RE-CAM regimen might be the riskiest one in inducing leukopenia because inhibition of P-glycoprotein by CAM may elevate the concentration of RFP in blood, enhancing leukopenia by RFP. Fortunately, in the majority of cases with leukopenia, severity was mild (grade1 to 2) and so they could continue treatment without changing the regimen. CLINICAL IMPLICATIONS: It's important to know the resoponsible drug and treatment for rush and leukopenia by anti-tuberculous chemotherapy to continue and complete the treatment. DISCLOSURE: The following authors have nothing to disclose: Shunichi Nishima No Product/Research Disclosure Information

Preliminary Experience of Endovascular Embolization Using N-Butyl Cyanoacrylate for Hemoptysis due to Infectious Pulmonary Artery Pseudoaneurysms via Systemic Arterial Approach

We report 5 patients with hemoptysis due to infectious pulmonary artery pseudoaneurysm (PAP) treated with endovascular embolization using N-butyl cyanoacrylate (NBCA) injected via bronchial and nonbronchial systemic arterial approaches. Infectious diseases included inactive tuberculosis (n = 3), nontuberculous mycobacteriosis (n = 1), and chronic infection of unknown origin (n = 1). Seven PAPs were detected on selective systemic angiography, and injection of NBCA was performed. Disappearance of all PAPs was confirmed on systemic arteriography after the intervention. In all patients, hemoptysis was stopped without major complications, and it did not recur during the follow-up period (mean, 351 d; range, 285–427 d).

Effects of nutritional and ambient oxygen condition on biofilm formation in Mycobacterium avium subsp. hominissuis via altered glycolipid expression

Mycobacterium avium subsp. hominissuis (MAH) is the major causative agent of nontuberculous mycobacteriosis, the representative case of environment-related infectious diseases the incidence of which is increasing in industrialized countries. MAH is found in biofilm in drinking water distribution system and residential environments. We investigated the effect of gaseous and nutritional conditions, and the role of glycopeptidolipids (GPLs) on biofilm-like pellicle formation in MAH. Pellicle formation was observed under 5% oxygen in Middlebrook 7H9 broth containing 0.2% glycerol and 10% albumin-dextrose-catalase enrichment but not under normoxia or in nutrient-poor media. An analysis of 17 environmental isolates revealed that hypoxia (5% oxygen) preferentially enhanced pellicle formation both in plastic plates and in glass tubes, compared with hypercapnia (5% carbon dioxide). Wild-type strains (WT) developed much thicker pellicles than GPL-deficient rough mutants (RM). WT bacterial cells distributed randomly and individually in contrast to that RM cells positioned linearly in a definite order. Exogenous supplementation of GPLs thickened the pellicles of RM, resulting in a similar morphological pattern to WT. These data suggest a significant implication of eutrophication and hypoxia in biofilm-like pellicle formation, and a functional role of GPLs on development of pellicles in MAH.

P1.08-037 Thoracoscopic Segmentectomy of Pulmonary Nodules after Computed Tomography–Assisted Bronchoscopic Metallic Coil Marking (2nd Version)

With advances in computed tomography (CT), small pulmonary lesions previously unseen on chest radiographs are being increasingly detected. Among lesions less than 10 mm in size, a considerable number of malignancies have been reported. To localize small and deeply situated pulmonary nodules during thoracoscopy with roentgenographic fluoroscopy, we developed a marking procedure that uses a metallic coil and a coin for thoracoscopic segmentectomy. Fifteen patients underwent video-assisted thoracoscopic surgery for removal of 16 pulmonary lesions between January 2011 and January 2016. There were 6 males and 9 females, with an average age of 68.3 years (range 54 to 78 years). Fluoroscopy-assisted thoracoscopic surgery after CT-assisted bronchoscopic metallic coil marking was performed using an ultrathin bronchoscope under bi-plain fluoroscopy viewing a coin on a patient’s chest wall. The coin was simulated a pulmonary lesion by the CT findings, and it was put on the patient's chest wall. During thoracoscopy, a C-arm-shaped roentgenographic fluoroscope was used to detect the radiopaque nodules. The nodule with coil markings was grasped with forceps and resected in segmentectomy under fluoroscopic and thoracoscopic guidance. The marking procedure took 11 to 49 minutes from insertion to removal of the bronchoscope. There were no complications from the marking, and all 16 nodules were easily localized by means of thoracoscopy. The metallic coil showed the nodules on the fluoroscopic monitor, which aided in nodule manipulation. Nodules were completely resected under thoracoscopic guidance in segmentectomy. The pathologic diagnosis was primary adenocarcinoma in 10 nodules, pulmonary metastases in 3 nodules, an atypical adenomatous hyperplasia in 1 nodule, a hamartoma in 1 nodule and a nontuberculous mycobacteriosis in 1 nodule. One case of an adenocarcinoma in situ with an extensive two segments was performed a curative segmentectomy. In this study, CT-guided transbronchial metallic coil marking with an ultrathin bronchoscope with a coin on a patient’s chest wall under bi-plain fluoroscopy after CT-assisted stimulation was found to be feasible and safe. In our previous report, CT had been needed at least three times, but this method needed only twice CT scan. It might be a useful method not only for making a diagnosis but also for therapeutic resection in selected early lung cancers.

肺癌術後にステープルラインに発生した炎症性腫瘤，非結核性抗酸菌症の2例

肺癌術後にステープルラインに発生した炎症性腫瘤，非結核性抗酸菌症の2例

同側他肺葉に肺非結核性抗酸菌症による肉芽腫を合併した原発性肺癌根治切除の1例

同側他肺葉に肺非結核性抗酸菌症による肉芽腫を合併した原発性肺癌根治切除の1例

Solitary pulmonary nodules due to non-tuberculous mycobacteriosis among 28 resected cases.

In some patients, non-tuberculous mycobacteria (NTM) infections manifest in solitary nodules (solitary nodular [SN] type) generally caused by Mycobacterium avium complex (MAC). In patients treated using surgical resection, the American Thoracic Society guidelines state that postoperative chemotherapy is not necessary in the absence of lesions, although there have been a few reports of such cases. Twenty-eight patients diagnosed with NTM who underwent solitary pulmonary nodule resection at Toneyama Hospital, Osaka, Japan, between January 2000 and October 2012 were enrolled. We evaluated the influence of the surgical procedure and chemotherapy on outcomes in this retrospective study. Of the 28 patients, 12 were males and 16 were females; the mean age was 58.6 ± 13.2 years. Twenty-five patients were asymptomatic and bronchoscopy was performed in 18; only 2 had a definitive diagnosis of NTM. The pathogen responsible was MAC in 27 patients and M. kansasii in 1. The surgical procedure used was wedge resection in 22 patients, segmentectomy in 1 and lobectomy in 5. Postoperative chemotherapy was administered to 9 patients. Twenty-six patients had no recurrence. We believe that wedge resection is a valid surgical intervention for SN type NTM; additional postoperative chemotherapy is unnecessary in cases with no residual lesions in the operated lung lobe.

Nontuberculous mycobacteria in patients with respiratory diseases (a clinical study)

Theaimof this study was to analyze medical reports of patients treated at the Federal Central Research Institute of Tuberculosis in 2011 to 2014.Methods.One hundred of medical reports have been analyzed. Nontuberculosis mycobacteria (NTM) were searched in sputum, bronchoalveolar lavage fluid or resected tissue samples. Microscopy of samples stainedmatographic rapid test for Mycobacterium tuberculosis complex antigen detection were used. Nontuberculous mycobacteriosis was diagnosed according to ATS criteria.Results.The patients were 20 to 78 years of age. Most patients had pulmonary tuberculosis (44%) and chronic non"specific inflammatory respiratory diseases (45%). Common clinical symptoms were cough (98.2%), dyspnea (72.4%), haemophtysis (10.3%), fatigue (68.5%), loss of appetite (32.3%), and weight loss (12.5%). Radiological signs were in line with the underlying disease and were as follows: pulmonary nodules (6%), disseminated lesions (6%), tuberculomas (7%), cavities (12%), pulmonary infiltrates (8%), bullae (42%), ground glass opacities (5%), honeycombing (2%, bronchiectasis (20%), intrathoracic lymph node enlargement (5%), cirrhotic pulmonary lesions (19%), and combination of various radiological signs (32%).Conclusion.Patients with chronic respiratory diseases, such as chronic obstructive pulmonary disease, bronchiectasis, cystic fibrosis, pneumoconiosis. etc.; patients on long"term therapy with systemic steroids, patients with pulmonary tuberculosis or with a history of pulmonary tuberculosis are at risk of having nontuberculous mycobacteriosis.

FREQUENCY OF DETECTION AND SPECIFIC MORPHOLOGY OF NON-TUBERCULOUS MYCOBACTERIOSIS IN THOSE AT THE ADVANCED STAGE OF HIV (AS PER DATA FROM ORENBURG REGION)

Goal: to define frequency of detection of non-tuberculous mycobacterioses in Orenburg Region and to study the morphology of the autopsy samples of the patients suffering from HIV infection and non-tuberculous mycobacteriosis. Materials and methods. 7488 mycobacterial cultures were analyzed in order to differentiate non-tuberculous mycobacteria and to identify their species by molecular genetic methods. Post mortem diagnostics was performed with morphological description of generalized forms of mycobacterioses caused by M. avium. Results. The analysis showed that species of Mycobacterium tuberculosis complex significantly prevailed (98.9%) in Orenburg Region. The following non-tuberculous mycobacteria were found in HIV negative patients: M. avium complex, M. xenopi, M. gordonae. M. avium was the most common in HIV positive patients (75%). Non-tuberculous mycobacteriosis possesses a specific diagnostic feature i.e. detection of non-caseous granulomas, consisting of histiocytes and "foamy" macrophages, containing large number of acid-fast mycobacteria in cytoplasm. Diffusive fibrosis of macrophage-histiocyte granulomas and sclerosis of tissue in perifocal area of inflammation are the typical features of it.

The Long-term Clinical Course of Chronic Eosinophilic Pneumonia.

Objective The long-term clinical course and prognosis of patients with chronic eosinophilic pneumonia (CEP) including factors predictive of the relapse of CEP have not been fully investigated. The aim of the present study was to investigate these issues. Methods We retrospectively investigated the rate of relapse and prognosis in 73 patients diagnosed as having CEP. Results Systemic corticosteroid therapy was administered at a prednisolone dose of 29.4±7.6 mg/day. During a median follow-up period of 1,939 days, 27 patients suffered from relapse of CEP. Two patients developed steroid-induced diabetes mellitus, and 1 patient developed pulmonary nontuberculous mycobacteriosis. Five patients died; however, none died of CEP. A history of smoking was the only independent negative risk factor for relapse of CEP [hazard ratio, 0.37 (0.14-0.98)]. Conclusion Patients with CEP frequently relapse. During the follow-up, metabolic and infectious complications under prolonged corticosteroid therapy are problematic. A history of smoking was a negative factor for predicting the risk of CEP relapse.

Pulmonary Nontuberculous Mycobacteriosis and Chronic Lower Respiratory Tract Infections in Patients with Allergic Bronchopulmonary Mycosis without Cystic Fibrosis.

Objective The frequency of pulmonary nontuberculous mycobacteriosis (pNTM), chronic lower respiratory tract infections (cLRTIs), and pneumonia in patients with allergic bronchopulmonary mycosis (ABPM) without cystic fibrosis has not yet been fully investigated. Methods We retrospectively analyzed 42 patients with ABPM focusing on the frequency of pNTM and cLRTIs, acute exacerbation of cLRTIs, and pneumonia. Results During a median follow-up period of 2,299 days (range, 118-6,138 days), 7 patients developed pNTM (mainly Mycobacterium avium complex), and 21 patients developed cLRTI (mostly from Staphylococcus aureus followed by Pseudomonas aeruginosa). Twelve patients developed 21 episodes of acute exacerbation of cLRTIs, and 4 patients developed pneumonia. Conclusion Patients with ABPM can have concomitant NTM infection and, not uncommonly, cLRTI, and they can also sometimes develop pneumonia or an acute exacerbation of cLRTI.

Nontuberculous Mycobacteriosis (Different Faces of Two Most Common Nontuberculous Mycobacteriosis)

Nontuberculous mycobacteriosis are chronic granulomatous diseases caused by different types of mycobacteria. Plain chest X-ray and high resolution computed tomography are highly nonspecific but absolutely neccesary in detection and follow-up of patients with pulmonary mycobacterial infection. Treatment of infection caused by Mycobacterium avium complex is often successful. However treatement is successful only in 55% of patients with pulmonary infection caused by Mycobacterium abscessus complex. The results of therapy is dependent on sensitivity to macrolides whitch are cornerstones of medical therapy. In our case serie of four patients with cystic fibrosis show that results of therapy in patients with preexistent lung disease can be very different and is not dependent only on type of mycobaterial infection and sensitivity to antimicrobial treatment. In such cases, therapy of Mycobacterium avium complex infection can last even several years.

肺非結核性抗酸菌症に対する手術術式の検討

肺非結核性抗酸菌症に対する手術術式の検討

Diversity and combinations of infectious agents in 38 adults with an infection-triggered reactive haemophagocytic syndrome: a multicenter study

Reactive haemophagocytic syndrome (HS) is a rare condition that occurs in patients with infections, haematological malignancies or autoimmune diseases. Although various microorganisms are thought to trigger HS, most of the literature data on this topic have been gathered in single-centre case series. Here, we sought to characterize infectious triggers in a large, multicentre cohort of patients with HS. Patients were included in the present study if HS was solely due to one or more infections. Detailed microbiological data were recorded. Of the 162 patients with HS in the cohort, 40 (25%) had at least one infection and 38 of the latter (including 14 women, 36.8%) were included. The median age was 46 years. Seven patients were presumed to be immunocompetent (18.4%), whereas 19 patients (50%) were infected with human immunodeficiency virus and 12 patients (31.6%) were immunocompromised for other reasons. Twenty-seven patients (71.1%) had a single infection, whereas six (15.8%) and five (13.1%) patients had, respectively, two and three concomitant infections. We observed pyogenic bacterial infections (n = 7), tuberculosis (n = 10), non-tuberculous mycobacteriosis (n = 3), viral infections (n = 17: 11 cytomegalovirus, three Epstein–Barr virus, two human herpesvirus 8, one herpes simplex virus 2), parasitic infections (n = 8: four disseminated toxoplasmosis, one leishmaniasis, three malaria), fungal infections (n = 5: four pulmonary pneumocystosis and one candidaemia). Eighteen patients (47.4%) received corticosteroids and/or etoposide. Twelve patients died (31.6%). All multiple infections and all deaths occurred in immunocompromised patients. When compared with patients suffering from malignancy-associated HS, patients with infection-triggered HS were younger and more likely to be immunocompromised, and had a better outcome.

Biological agents and respiratory infections: Causative mechanisms and practice management.

Biological agents are increasingly being used to treat patients with immune-mediated inflammatory disease. In Japan, currently approved biological agents for patients with rheumatoid arthritis (RA) include tumor necrosis factor inhibitors, interleukin-6 receptor-blocking monoclonal antibody, and T-cell costimulation inhibitor. Rheumatologists have recognized that safety issues are critical aspects of treatment decisions in RA. Therefore, a wealth of safety data has been gathered from a number of sources, including randomized clinical trials and postmarketing data from large national registries. These data revealed that the most serious adverse events from these drugs are respiratory infections, especially pneumonia, tuberculosis, nontuberculous mycobacteriosis, and Pneumocystis jirovecii pneumonia, and that the most common risk factors associated with these respiratory infections are older age, concomitant corticosteroid use, and underlying respiratory comorbidities. Because of this background, in 2014, the Japanese Respiratory Society published their consensus statement of biological agents and respiratory disorders. This review summarizes this statement and adds recent evidence, especially concerning respiratory infections in RA patients, biological agents and respiratory infections, and practice management of respiratory infections in patients treated with biological agents. To decrease the incidence of infections and reduce mortality, we should know the epidemiology, risk factors, management, and methods of prevention of respiratory infections in patients receiving biological agents.

Epidemiology and clinical features of pulmonary nontuberculous mycobacteriosis in Nagasaki, Japan.

Background and ObjectivesRecent reports indicate that the incidence of nontuberculous mycobacterial-lung disease (NTM-LD) is increasing. This study aimed to investigate the epidemiology and clinical features of NTM-LD patients in Nagasaki prefecture, Japan to identify the negative prognostic factors for NTM-LD in Japan.MethodsThe medical records of patients newly diagnosed with NTM-LD in eleven hospitals in Nagasaki prefecture between January 2001 and February 2010 were reviewed. Data regarding the annual population of each region and the incidence of all forms of tuberculosis were collected to assess geographic variations in NTM-LD incidence, isolates, and radiological features.ResultsA total 975 patients were diagnosed with NTM-LD. The incidence increased over the study period and reached 11.0 and 10.1 per 100,000 population in 2008 and 2009, respectively. M. intracellulare was the most common pathogen in the southern region, and M. avium most common in other regions. The most common radiographic pattern was the nodular-bronchiectatic pattern. Age >60 years, body mass index <18.5 kg/m2, underlying lung disease, and cavitary pattern were the negative prognostic factors at the 1-year follow-up.ConclusionsThe incidence of NTM-LD has been increasing in Nagasaki prefecture. The isolates and radiographic features of patients vary markedly by region.

Possible role of anaerobes in the pathogenesis of nontuberculous mycobacterial infection.

Recent advances in cultivation-independent molecular biological modalities for detecting bacterial species have indicated that several bacterial species may play a role in the pathogenesis of certain infectious diseases. The aim of this study was to evaluate the role of bacterial flora in the pathogenesis of nontuberculous mycobacteriosis (NTM) using a bacterial floral analysis of bronchoalveolar lavage fluid (BALF) with 16S rRNA gene sequencing in patients with bronchiectasis. Fifty-eight patients with bronchiectasis evaluated using chest computed tomography were enrolled. BALF obtained from the most affected lung lesions was evaluated using culture and culture-independent methodologies. Approximately 600 bp of the bacterial 16S rRNA gene (E341F-E907R) was amplified via polymerase chain reaction using universal primers, and clone libraries were constructed. Nucleotide sequences of 96 randomly chosen clones for each specimen were determined, and the homology was searched using a basic local alignment search tool to determine the bacterial phylotypes and their proportions (bacterial floral analysis) in each specimen. Twenty-nine patients with bronchiectasis were diagnosed with NTM based on culture-based methods using Ogawa medium. The molecular method showed a significantly high rate of anaerobes among the patients with NTM compared with that observed in the bronchiectasis patients without NTM. In addition, findings of collapse/consolidation were significantly related to the proportion of Prevotella species in the BALF samples determined using the molecular method (P < 0.001). Given the results of the present study, anaerobes may play an important role in the pathogenesis of bronchiectasis in patients with NTM.

The malaria co-infection challenge: An investigation into the antimicrobial activity of selected Guinean medicinal plants

Ethnopharmacological relevanceIn sub-Saharan Africa, concomitant occurrence of malaria and invasive infections with micro-organisms such as Gram-positive Staphylococcus aureus, Gram-negative Escherichia coli and yeasts or fungi such as Candida albicans and Aspergillus fumigatus is common. Non-tuberculous mycobacteriosis caused by Mycobacterium chelonae has been recognized as a pulmonary pathogen with increasing frequency without effective therapy. Although less important, the high incidence of Trichophyton rubrum infections along with its ability to evade host defense mechanisms, accounts for the high prevalence of infections with this dermatophyte. Considering the treatment cost of both malaria and microbial infections, along with the level of poverty, most affected African countries are unable to cope with the burden of these diseases. In sub-Saharan Africa, many plant species are widely used in the treatment of these diseases which are traditionally diagnosed through the common symptom of fever. Therefore it is of interest to evaluate the antimicrobial activities of medicinal plants reported for their use against malaria/fever. Materials and methodsBased on an ethnobotanical survey, 34 Guinean plant species widely used in the traditional treatment of fever and/or malaria have been collected and evaluated for their antimicrobial activities. Plants extracts were tested against Candida albicans, Trichophyton rubrum, Aspergillus fumigatus, Mycobacterium chelonae, Staphylococcus aureus and Escherichia coli. ResultsThe most interesting activities against Candida albicans were obtained for the polar extracts of Pseudospondias microcarpa and Ximenia americana with IC50 values of 6.99 and 8.12µg/ml, respectively. The most pronounced activity against Trichophyton rubrum was obtained for the ethanol extract of Terminalia macroptera (IC50 5.59µg/ml). Only 7 of the 51 tested extracts were active against Staphylococcus aureus. From these, the methanolic extracts of the leaves and stem bark of Alchornea cordifolia were the most active with IC50 values of 2.81 and 7.47µg/ml, respectively. Only Terminalia albida and Lawsonia inermis showed activity against Mycobacterium chelonae. None of the tested extracts was active against Escherichia coli. ConclusionA number of traditional Guinean plant species used against malaria/fever showed, in addition to their antiplasmodial properties and antimicrobial activity. The fact that some plant species are involved in the traditional treatment of malaria/fever without any antiplasmodial evidence may be justified by their antimicrobial activities.

ソフト凝固法による嚢胞焼灼術を行った非結核性抗酸菌症合併続発性気胸の1例

ソフト凝固法による嚢胞焼灼術を行った非結核性抗酸菌症合併続発性気胸の1例

Patients with MAC Lung Disease Have a Low Visceral Fat Area and Low Nutrient Intake.

Objective. This study aimed to examine the nutritional status and nutrient intake of patients with MAC lung disease with a focus on visceral fat area. Patients and Methods. Among 116 patients of our hospital with nontuberculous mycobacteriosis who were registered between May 2010 and August 2011, 103 patients with MAC lung disease were included in this study. In all patients, nutritional status and nutrient intake were prospectively examined. Results. Patients were 23 men and 80 women (mean age, 72.3 ± 10.9 years). BMI (kg/m2) at the time of registration was 20.4 ± 2.7 in men and 19.2 ± 2.9 in women. Visceral fat area (cm2) was significantly lower in women (35.7 ± 26.6) than in men (57.5 ± 47.4) (p = 0.0111). The comparison with general healthy adults according to age revealed a markedly reduced visceral fat area among patients with MAC lung disease. With respect to nutrient intake, energy adequacy (86.1 ± 15.7%), protein adequacy (82.4 ± 18.2%), lipid adequacy (78.1 ± 21.8%), and carbohydrate adequacy (89.6 ± 19.2%) ratios were all low at the time of registration. BMI was significantly correlated with protein adequacy (p = 0.0397) and lipid adequacy (p = 0.0214) ratios, while no association was found between visceral fat area and nutrient intake. Conclusion. Patients with MAC lung disease had a low visceral fat area and low nutrient intake.