[A clinical study of deceased cases of pulmonary M. Avium complex (MAC) disease--: in contrast with survived cases followed-up for 5 years or longer].

We performed a clinical study of pulmonary M. avium complex (MAC) disease comparing decreased cases and survived cases followed-up for 5 years or longer. The results were as follows: 1. At the time of starting the initial medical treatment for pulmonary MAC disease, the deceased cases were older than the survived cases, and the deceased cases were severe than the survived cases in clinical conditions. The spread of the lesions was more extensive and cavities were more frequently observed in the deceased cases than in the survived cases. 2. We classified the clinical pattern of pulmonary MAC disease into a primary infection type and a secondary infection type. Then, we subclassified the primary infection type into a localized type, which contained a tuberculosis-like type and middle, lingular or other lobar pneumonia type, and a diffuse type. The secondary infection type was more frequent in the deceased cases than in the survived cases, and any middle, lingular or other lobar pneumonia type was not observed in the deceased cases. 3. We classified the mode of progression of pulmonary MAC disease in the deceased cases into a tuberculosis-like progression and a diffuse progression. The tuberculosis-like type and the secondary infection type frequently showed the tuberculosis-like progression and the diffuse type frequently showed the diffuse progression. The patients who showed the tuberculosis-like progression were frequently sputum culture positive for MAC, while all patients showing the diffuse progression were culture negative at the time of death. An interval from the estimated onset of the disease to death was shorter in the tuberculosis-like progression type than in the diffuse progression type.