Non-localized Mycobacterium avium lung disease successfully treated with lobectomy and chemotherapy.

A 17-year-old boy presented with a large cavity and bilateral nodular opacities on his chest roentgenogram. Mycobacterium avium was identified in his sputum. According to the recommendations of the American Thoracic Society, he was not strongly recommended to undergo surgery because of non-localized lesions. But since cavities can provide a means for disease to spread to other lobes, we decided to perform a lobectomy including the cavity combined with chemotherapy. Now he has been well for 4 years without exacerbation. There is a possibility of long-term remission with this combination treatment in cases a destructive lesion of airway such as a cavity which is localized to one lobe, even if other lesions such as nodular opacities exist in many other lobes.