{"id":3844,"date":"2025-07-26T17:02:44","date_gmt":"2025-07-26T08:02:44","guid":{"rendered":"https:\/\/plaza.umin.ac.jp\/~OIO\/?p=3844"},"modified":"2025-07-26T17:18:17","modified_gmt":"2025-07-26T08:18:17","slug":"case-records-of-the-massachusetts-general-hospital%e3%82%88%e3%82%8a","status":"publish","type":"post","link":"https:\/\/plaza.umin.ac.jp\/~OIO\/?p=3844","title":{"rendered":"Case Records of the Massachusetts General Hospital\u3088\u308a"},"content":{"rendered":"\n<p><a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMcpc2412532\">Case 21-2025: A 75-Year-Old Man with Cough, Dyspnea, and Hypoxemia<\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMcpc2412532\">\u8868\u984c\u306e\u8ad6\u6587<\/a>\u3092AI\u3068\u3068\u3082\u306b\u8aad\u307f\u8fbc\u307f\u307e\u3057\u305f<\/h2>\n\n\n\n<p>\uff08\u672c\u8a18\u4e8b\u306f\u5143\u6587\u732e\u3092\u898b\u306a\u304c\u3089\u8aad\u3093\u3067\u3044\u305f\u3060\u304f\u524d\u63d0\u3067\u3059\u306e\u3067\u3001\u8a73\u7d30\u306a\u75c5\u6b74\u3001\u753b\u50cf\u3084\u81e8\u5e8a\u691c\u67fb\u6240\u898b\u7b49\u306f\u5143\u6587\u732e\u3092\u3054\u53c2\u7167\u304f\u3060\u3055\u3044\uff09<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">1. \u3069\u3093\u306a\u3082\u306e\uff1f<\/h3>\n\n\n\n<p>\u672c\u8ad6\u6587\u306f\u3001\u54b3\u3001\u547c\u5438\u56f0\u96e3\u3001\u304a\u3088\u3073\u4f4e\u9178\u7d20\u8840\u75c7\u3092\u5448\u3059\u308b75\u6b73\u306e\u7537\u6027\u306e\u75c7\u4f8b\u3092\u5831\u544a\u3057\u3066\u3044\u307e\u3059\u3002\u60a3\u8005\u306f\u3001\u65e2\u5b58\u306e\u91cd\u75c7\u5598\u606f\u3068\u30a2\u30ec\u30eb\u30ae\u30fc\u6027\u6c17\u7ba1\u652f\u80ba\u30a2\u30b9\u30da\u30eb\u30ae\u30eb\u30b9\u75c7\uff08ABPA\uff09\u306e\u75c5\u6b74\u304c\u3042\u308a\u3001\u30b0\u30eb\u30b3\u30b3\u30eb\u30c1\u30b3\u30a4\u30c9\u3092\u9577\u671f\u306b\u308f\u305f\u3063\u3066\u4f7f\u7528\u3057\u3066\u3044\u307e\u3057\u305f\u3002\u5165\u9662\u6642\u306eCT\u753b\u50cf\u691c\u67fb\u3067\u306f\u3001\u53f3\u80ba\u4e0a\u8449\u306b\u7a7a\u6d1e\u6027\u75c5\u5909\u3001\u4e21\u4e0b\u8449\u306b\u816b\u7624\u69d8\u6d78\u6f64\u5f71\u304c\u8a8d\u3081\u3089\u308c\u307e\u3057\u305f\u3002\u81e8\u5e8a\u7d4c\u904e\u3068\u691c\u67fb\u7d50\u679c\u304b\u3089\u3001\u30ce\u30ab\u30eb\u30b8\u30a2\u30fb\u30d5\u30a1\u30fc\u30b7\u30cb\u30ab\u8907\u5408\u4f53\u3068\u975e\u7d50\u6838\u6027\u6297\u9178\u83cc\uff08NTM\uff09\u3067\u3042\u308b\u30de\u30a4\u30b3\u30d0\u30af\u30c6\u30ea\u30a6\u30e0\u30fb\u30a2\u30d6\u30bb\u30c3\u30b5\u30b9\u8907\u5408\u4f53\u306b\u3088\u308b\u6df7\u5408\u611f\u67d3\u304c\u6700\u7d42\u7684\u306a\u8a3a\u65ad\u3068\u3057\u3066\u78ba\u5b9a\u3055\u308c\u307e\u3057\u305f\u3002\u3053\u306e\u75c7\u4f8b\u306f\u3001\u514d\u75ab\u6291\u5236\u72b6\u614b\u306b\u3042\u308b\u60a3\u8005\u306b\u304a\u3051\u308b\u65e5\u548c\u898b\u611f\u67d3\u75c7\u306e\u8a3a\u65ad\u306e\u8907\u96d1\u3055\u3068\u3001\u591a\u5264\u4f75\u7528\u7642\u6cd5\u304a\u3088\u3073\u9577\u671f\u6cbb\u7642\u306e\u5fc5\u8981\u6027\u3092\u793a\u3057\u3066\u3044\u307e\u3059\u3002\u7279\u306b\u3001\u30ce\u30ab\u30eb\u30b8\u30a2\u3068\u30de\u30a4\u30b3\u30d0\u30af\u30c6\u30ea\u30a6\u30e0\u306e\u540c\u6642\u611f\u67d3\u3068\u3044\u3046\u7a00\u306a\u30b1\u30fc\u30b9\u3067\u3042\u308a\u3001\u57f9\u990a\u6761\u4ef6\u306e\u5de5\u592b\u306b\u3088\u3063\u3066\u521d\u3081\u3066\u4e21\u65b9\u306e\u75c5\u539f\u4f53\u304c\u7279\u5b9a\u3055\u308c\u305f\u70b9\u304c\u6280\u8853\u7684\u65b0\u898f\u6027\u3068\u3057\u3066\u6319\u3052\u3089\u308c\u307e\u3059\u3002\u60f3\u5b9a\u3055\u308c\u308b\u30e6\u30fc\u30b9\u30b1\u30fc\u30b9\u306f\u3001\u514d\u75ab\u4e0d\u5168\u60a3\u8005\u306b\u304a\u3051\u308b\u539f\u56e0\u4e0d\u660e\u306e\u80ba\u75c5\u5909\u306b\u5bfe\u3059\u308b\u9451\u5225\u8a3a\u65ad\u3068\u6cbb\u7642\u6226\u7565\u306e\u78ba\u7acb\u3067\u3059\u3002\u672c\u7814\u7a76\u306f\u3001\u307e\u308c\u306a\u6df7\u5408\u611f\u67d3\u75c7\u306e\u8a3a\u65ad\u3068\u6cbb\u7642\u306b\u95a2\u3059\u308b\u77e5\u898b\u3092\u63d0\u4f9b\u3057\u3001\u7279\u306b\u30b0\u30eb\u30b3\u30b3\u30eb\u30c1\u30b3\u30a4\u30c9\u9577\u671f\u4f7f\u7528\u8005\u306b\u304a\u3051\u308b\u65e5\u548c\u898b\u611f\u67d3\u75c7\u306e\u53ef\u80fd\u6027\u3092\u5f37\u8abf\u3057\u3066\u3044\u307e\u3059\u3002 <sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><sup><\/sup><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">2. \u3069\u3046\u3084\u3063\u3066\u8a3a\u65ad\u3057\u305f\uff1f<\/h3>\n\n\n\n<p>\u672c\u75c7\u4f8b\u306f\u3001\u81e8\u5e8a\u75c7\u72b6\u3001\u753b\u50cf\u6240\u898b\u3001\u304a\u3088\u3073\u5fae\u751f\u7269\u5b66\u7684\u691c\u67fb\u306b\u57fa\u3065\u3044\u3066\u8a3a\u65ad\u3055\u308c\u307e\u3057\u305f\u3002 <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u521d\u671f\u8a55\u4fa1\u3068\u753b\u50cf\u8a3a\u65ad<\/strong>: \u60a3\u8005\u306f\u9032\u884c\u6027\u306e\u547c\u5438\u56f0\u96e3\u3001\u54b3\u3001\u4f4e\u9178\u7d20\u8840\u75c7\u3067\u5165\u9662\u3057\u307e\u3057\u305f\u3002 \u80f8\u90e8X\u7dda\u5199\u771f\u3067\u306f\u5de6\u80ba\u5e95\u90e8\u306b\u6d78\u6f64\u5f71\u3001\u53f3\u80ba\u306b\u7a7a\u6c17\u8154\u6d78\u6f64\u5f71\u304c\u8a8d\u3081\u3089\u308c\u307e\u3057\u305f\u3002 \u80f8\u90e8CT\u3067\u306f\u3001\u5de6\u4e0b\u8449\u3092\u4e2d\u5fc3\u306b\u820c\u533a\u304a\u3088\u3073\u5de6\u4e0a\u8449\u5f8c\u4e0a\u533a\u57df\u306b\u53ca\u3076\u816b\u7624\u69d8\u6d78\u6f64\u5f71\u3068\u6c17\u7ba1\u652f\u306e\u4e0d\u900f\u660e\u5316\u3001\u672b\u68a2\u306e\u3059\u308a\u30ac\u30e9\u30b9\u9670\u5f71\u304c\u78ba\u8a8d\u3055\u308c\u307e\u3057\u305f\u3002\u307e\u305f\u3001\u53f3\u4e0b\u8449\u306b\u3082\u5225\u306e\u816b\u7624\u69d8\u6d78\u6f64\u5f71\u3068\u3001\u5468\u56f2\u306b\u3059\u308a\u30ac\u30e9\u30b9\u9670\u5f71\u3092\u4f34\u3046\u8907\u6570\u306e\u5145\u5b9f\u6027\u7d50\u7bc0\u3001\u53f3\u80ba\u4e0a\u8449\u5f8c\u533a\u57df\u306b\u306f\u76f4\u5f843.2 cm\u306e\u7a7a\u6d1e\u6027\u816b\u7624\u304c\u8a8d\u3081\u3089\u308c\u307e\u3057\u305f\u3002 \u3053\u308c\u3089\u306e\u753b\u50cf\u6240\u898b\u306f\u3001\u708e\u75c7\u6027\u75be\u60a3\u3001\u764c\u3001\u611f\u67d3\u75c7\u306e\u53ef\u80fd\u6027\u3092\u793a\u5506\u3057\u307e\u3057\u305f\u3002 <\/li>\n\n\n\n<li><strong>\u5fae\u751f\u7269\u5b66\u7684\u691c\u67fb<\/strong>:\n<ul class=\"wp-block-list\">\n<li><strong>\u30b0\u30e9\u30e0\u67d3\u8272<\/strong>: \u5580\u75f0\u306e\u30b0\u30e9\u30e0\u67d3\u8272\u3067\u306f\u3001\u30d5\u30a3\u30e9\u30e1\u30f3\u30c8\u72b6\u3001\u5206\u5c90\u72b6\u3001\u30d3\u30fc\u30ba\u72b6\u306e\u30b0\u30e9\u30e0\u967d\u6027\u687f\u83cc\u304c\u8a8d\u3081\u3089\u308c\u307e\u3057\u305f\u3002\u3053\u308c\u306f\u7279\u306b\u30ce\u30ab\u30eb\u30b8\u30a2\u5c5e\u306e\u7279\u5fb4\u3067\u3057\u305f\u3002 <\/li>\n\n\n\n<li><strong>\u5909\u6cd5\u6297\u9178\u83cc\u67d3\u8272<\/strong>: \u5580\u75f0\u306e\u5909\u6cd5\u6297\u9178\u83cc\u67d3\u8272\u3067\u306f\u3001\u30ce\u30ab\u30eb\u30b8\u30a2\u3068\u4e00\u81f4\u3059\u308b\u8d64\u30d4\u30f3\u30af\u8272\u306e\u5fae\u751f\u7269\u304c\u78ba\u8a8d\u3055\u308c\u307e\u3057\u305f\u3002\u3053\u308c\u306f\u30df\u30b3\u30fc\u30eb\u9178\u3092\u5c11\u91cf\u7523\u751f\u3059\u308b\u30ce\u30ab\u30eb\u30b8\u30a2\u3068\u3001\u30df\u30b3\u30fc\u30eb\u9178\u3092\u7523\u751f\u3057\u306a\u3044\u30a2\u30af\u30c1\u30ce\u30df\u30bb\u30b9\u3092\u9451\u5225\u3059\u308b\u306e\u306b\u5f79\u7acb\u3061\u307e\u3057\u305f\u3002 <\/li>\n\n\n\n<li><strong>\u30aa\u30fc\u30e9\u30df\u30f3-\u30ed\u30fc\u30c0\u30df\u30f3\u86cd\u5149\u67d3\u8272<\/strong>: \u5580\u75f0\u306e\u30aa\u30fc\u30e9\u30df\u30f3-\u30ed\u30fc\u30c0\u30df\u30f3\u86cd\u5149\u67d3\u8272\u3067\u306f\u3001\u77ed\u3044\u6297\u9178\u83cc\u304c\u691c\u51fa\u3055\u308c\u3001\u30de\u30a4\u30b3\u30d0\u30af\u30c6\u30ea\u30a2\u3068\u306e\u6df7\u5408\u611f\u67d3\u304c\u793a\u5506\u3055\u308c\u307e\u3057\u305f\u3002 <\/li>\n\n\n\n<li><strong>\u57f9\u990a<\/strong>:\n<ul class=\"wp-block-list\">\n<li>\u901a\u5e38\u306e\u57f9\u990a\u3067\u306f8\u65e5\u9593\u306e\u57f9\u990a\u5f8c\u3001\u30ef\u30c3\u30af\u30b9\u72b6\u306e\u9ec4\u8272\u30b3\u30ed\u30cb\u30fc\u304c\u7d14\u7c8b\u57f9\u990a\u3055\u308c\u3001\u8cea\u91cf\u5206\u6790\u306b\u3088\u308a<em>Nocardia farcinica<\/em>\u8907\u5408\u4f53\u3068\u540c\u5b9a\u3055\u308c\u307e\u3057\u305f\u3002 <\/li>\n\n\n\n<li>\u30ce\u30ab\u30eb\u30b8\u30a2\u306e\u5897\u6b96\u3092\u6291\u5236\u3059\u308b\u305f\u3081\u306b\u30b7\u30e5\u30a6\u9178\u3067\u51e6\u7406\u3057\u305f\u5580\u75f0\u30b5\u30f3\u30d7\u30eb\u30927\u65e5\u9593\u57f9\u990a\u3057\u305f\u3068\u3053\u308d\u3001\u4e7e\u71e5\u3057\u305f\u767d\u8272\u30b3\u30ed\u30cb\u30fc\u304c\u7d14\u7c8b\u57f9\u990a\u3055\u308c\u3001\u8cea\u91cf\u5206\u6790\u306b\u3088\u308a<em>M. abscessus<\/em>\u8907\u5408\u4f53\u3068\u540c\u5b9a\u3055\u308c\u307e\u3057\u305f\u3002 <\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>\u75c5\u7406\u7d44\u7e54\u5b66\u7684\u691c\u67fb<\/strong>: \u7d4c\u6c17\u7ba1\u652f\u751f\u691c\u306e\u7d44\u7e54\u306e\u30b0\u30ed\u30b3\u30c3\u30c8\u30e1\u30bb\u30ca\u30df\u30f3\u9280\u67d3\u8272\u3067\u306f\u3001\u7d041\u30df\u30af\u30ed\u30f3\u5e45\u306e\u30d5\u30a3\u30e9\u30e1\u30f3\u30c8\u72b6\u3001\u5206\u5c90\u72b6\u306e\u5fae\u751f\u7269\u306e\u6d78\u6f64\u304c\u78ba\u8a8d\u3055\u308c\u3001\u30ce\u30ab\u30eb\u30b8\u30a2\u611f\u67d3\u3068\u4e00\u81f4\u3057\u307e\u3057\u305f\u3002 \u6297\u9178\u83cc\u67d3\u8272\u306f\u9670\u6027\u3067\u3057\u305f\u3002 <\/li>\n\n\n\n<li><strong>\u6cbb\u7642\u3078\u306e\u53cd\u5fdc<\/strong>: \u60a3\u8005\u306f\u3001\u30ce\u30ab\u30eb\u30b8\u30a2\u75c7\u306b\u5bfe\u3059\u308b\u6cbb\u7642\u3068\u3057\u3066\u3001\u9759\u8108\u5185\u30c8\u30ea\u30e1\u30c8\u30d7\u30ea\u30e0-\u30b9\u30eb\u30d5\u30a1\u30e1\u30c8\u30ad\u30b5\u30be\u30fc\u30eb\u3068\u30a4\u30df\u30da\u30cd\u30e0\u306e\u4f75\u7528\u7642\u6cd5\u3092\u958b\u59cb\u3057\u307e\u3057\u305f\u3002 \u305d\u306e\u5f8c\u3001\u547c\u5438\u56f0\u96e3\u3068\u4f4e\u9178\u7d20\u8840\u75c7\u306f\u6539\u5584\u3057\u3001\u9178\u7d20\u98fd\u548c\u5ea6\u3082\u6539\u5584\u3057\u307e\u3057\u305f\u3002 \u6cbb\u76423\u30f6\u6708\u5f8c\u306e\u80f8\u90e8CT\u3067\u306f\u3001\u4ee5\u524d\u8a8d\u3081\u3089\u308c\u305f\u591a\u767a\u6027\u6d78\u6f64\u5f71\u304c\u307b\u307c\u6d88\u5931\u3057\u3001\u80f8\u6c34\u3082\u89e3\u6d88\u3057\u3066\u3044\u307e\u3057\u305f\u3002 \u3053\u308c\u3089\u306e\u6cbb\u7642\u3078\u306e\u826f\u597d\u306a\u53cd\u5fdc\u304c\u3001\u8a3a\u65ad\u306e\u6b63\u5f53\u6027\u3092\u3055\u3089\u306b\u88cf\u4ed8\u3051\u307e\u3057\u305f\u3002 <\/li>\n<\/ul>\n\n\n\n<p>\u4ee5\u4e0a\u306e\u591a\u89d2\u7684\u306a\u691c\u67fb\u3068\u6cbb\u7642\u3078\u306e\u53cd\u5fdc\u306b\u3088\u308a\u3001\u672c\u75c7\u4f8b\u306b\u304a\u3051\u308b<\/p>\n\n\n\n<p><em>Nocardia farcinica<\/em>\u8907\u5408\u4f53\u3068<em>Mycobacterium abscessus<\/em>\u8907\u5408\u4f53\u306e\u6df7\u5408\u611f\u67d3\u3068\u8a3a\u65ad\u3055\u308c\u307e\u3057\u305f\u3002 <\/p>\n\n\n\n<h3 class=\"wp-block-heading\">3. \u3069\u3046\u3059\u3054\u3044\uff1f<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u7a00\u306a\u6df7\u5408\u611f\u67d3\u75c7\u306e\u7279\u5b9a<\/strong>: \u30ce\u30ab\u30eb\u30b8\u30a2\u75c7\u3068\u975e\u7d50\u6838\u6027\u6297\u9178\u83cc\uff08NTM\uff09\u611f\u67d3\u75c7\u306e\u6df7\u5408\u611f\u67d3\u306f\u7a00\u3067\u3042\u308a\u3001\u7279\u306b\u30b0\u30eb\u30b3\u30b3\u30eb\u30c1\u30b3\u30a4\u30c9\u9577\u671f\u4f7f\u7528\u8005\u3068\u3044\u3046\u514d\u75ab\u6291\u5236\u72b6\u614b\u306e\u60a3\u8005\u3067\u540c\u6642\u306b\u767a\u75c7\u3057\u305f\u30b1\u30fc\u30b9\u306f\u3001\u9451\u5225\u8a3a\u65ad\u306e\u96e3\u3057\u3055\u3092\u793a\u3057\u3066\u3044\u307e\u3059\u3002\u672c\u75c7\u4f8b\u3067\u306f\u3001\u901a\u5e38\u306e\u5580\u75f0\u57f9\u990a\u3067\u306f\u30ce\u30ab\u30eb\u30b8\u30a2\u304c\u512a\u52e2\u306b\u5897\u6b96\u3057\u3001NTM\u304c\u691c\u51fa\u3055\u308c\u306a\u3044\u53ef\u80fd\u6027\u304c\u3042\u308a\u307e\u3057\u305f\u304c\u3001\u30ce\u30ab\u30eb\u30b8\u30a2\u306e\u5897\u6b96\u3092\u6291\u5236\u3059\u308b\u7279\u6b8a\u51e6\u7406\uff08\u30b7\u30e5\u30a6\u9178\u51e6\u7406\uff09\u3092\u884c\u3046\u3053\u3068\u3067\u3001\u521d\u3081\u3066<em>M. abscessus<\/em>\u8907\u5408\u4f53\u306e\u5b58\u5728\u3092\u660e\u3089\u304b\u306b\u3057\u307e\u3057\u305f\u3002  \u3053\u306e\u8a3a\u65ad\u624b\u6cd5\u306f\u3001\u3053\u308c\u307e\u3067\u306e\u30eb\u30fc\u30c1\u30f3\u306a\u691c\u67fb\u3067\u306f\u898b\u904e\u3054\u3055\u308c\u3066\u3044\u305f\u53ef\u80fd\u6027\u306e\u3042\u308b\u6df7\u5408\u611f\u67d3\u75c7\u306e\u7279\u5b9a\u306b\u65b0\u305f\u306a\u9053\u3092\u958b\u304f\u3082\u306e\u3067\u3059\u3002<\/li>\n\n\n\n<li><strong>\u8a3a\u65ad\u7684\u30a2\u30d7\u30ed\u30fc\u30c1\u306e\u7cbe\u7dfb\u5316<\/strong>: \u30b0\u30e9\u30e0\u67d3\u8272\u3001\u5909\u6cd5\u6297\u9178\u83cc\u67d3\u8272\u3001\u30aa\u30fc\u30e9\u30df\u30f3-\u30ed\u30fc\u30c0\u30df\u30f3\u86cd\u5149\u67d3\u8272\u3001\u305d\u3057\u3066\u7279\u7570\u7684\u306a\u57f9\u990a\u6761\u4ef6\u3092\u7d44\u307f\u5408\u308f\u305b\u308b\u3053\u3068\u3067\u3001\u5f62\u614b\u5b66\u7684\u306b\u985e\u4f3c\u3059\u308b\u304c\u6cbb\u7642\u6cd5\u304c\u7570\u306a\u308b\u8907\u6570\u306e\u5fae\u751f\u7269\u3092\u6b63\u78ba\u306b\u9451\u5225\u3057\u307e\u3057\u305f\u3002  \u3053\u308c\u306f\u3001\u8907\u96d1\u306a\u80ba\u75c5\u5909\u3092\u6301\u3064\u514d\u75ab\u4e0d\u5168\u60a3\u8005\u306b\u5bfe\u3059\u308b\u8a3a\u65ad\u7684\u30ef\u30fc\u30af\u30d5\u30ed\u30fc\u306b\u304a\u3044\u3066\u91cd\u8981\u306a\u793a\u5506\u3092\u4e0e\u3048\u307e\u3059\u3002<\/li>\n\n\n\n<li><strong>\u6cbb\u7642\u6226\u7565\u3078\u306e\u793a\u5506<\/strong>: \u30ce\u30ab\u30eb\u30b8\u30a2\u75c7\u3068NTM\u611f\u67d3\u75c7\u306f\u7570\u306a\u308b\u6cbb\u7642\u30ec\u30b8\u30e1\u30f3\u3092\u5fc5\u8981\u3068\u3057\u307e\u3059\u304c\u3001\u4e21\u65b9\u306e\u75c5\u539f\u4f53\u3092\u7279\u5b9a\u3059\u308b\u3053\u3068\u3067\u3001\u305d\u308c\u305e\u308c\u306e\u611f\u67d3\u75c7\u306b\u52b9\u679c\u7684\u306a\u6297\u83cc\u85ac\u3092\u614e\u91cd\u306b\u9078\u629e\u3057\u3001\u4e0d\u9069\u5207\u306a\u5358\u5264\u7642\u6cd5\u3092\u907f\u3051\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u3057\u305f\u3002 \u3053\u306e\u30a2\u30d7\u30ed\u30fc\u30c1\u306f\u3001\u85ac\u5264\u8010\u6027\u83cc\u306e\u51fa\u73fe\u3092\u9632\u304e\u3001\u6cbb\u7642\u52b9\u679c\u3092\u6700\u5927\u5316\u3059\u308b\u305f\u3081\u306b\u6975\u3081\u3066\u91cd\u8981\u3067\u3059\u3002\u7279\u306b\u3001\u5e83\u7bc4\u306a\u80ba\u75c5\u5909\u3084\u64ad\u7a2e\u6027\u75be\u60a3\u306e\u5834\u5408\u3001\u9759\u8108\u5185\u6297\u83cc\u85ac\u306e\u4f75\u7528\u7642\u6cd5\u304c\u63a8\u5968\u3055\u308c\u308b\u30ce\u30ab\u30eb\u30b8\u30a2\u75c7\u306e\u6cbb\u7642\u3092\u9069\u5207\u306b\u884c\u3048\u305f\u3053\u3068\u306f\u3001\u60a3\u8005\u306e\u4e88\u5f8c\u6539\u5584\u306b\u76f4\u7d50\u3057\u307e\u3057\u305f\u3002 <\/li>\n\n\n\n<li><strong>\u81e8\u5e8a\u7684\u610f\u7fa9<\/strong>: \u30b0\u30eb\u30b3\u30b3\u30eb\u30c1\u30b3\u30a4\u30c9\u306e\u9577\u671f\u4f7f\u7528\u306f\u3001\u30ce\u30ab\u30eb\u30b8\u30a2\u611f\u67d3\u75c7\u306b\u5bfe\u3059\u308b\u611f\u53d7\u6027\u3092\u9ad8\u3081\u308b\u3053\u3068\u304c\u77e5\u3089\u308c\u3066\u3044\u307e\u3059\u304c  \u3001\u672c\u75c7\u4f8b\u306f\u3001\u305d\u306e\u30ea\u30b9\u30af\u304cNTM\u306e\u3088\u3046\u306a\u4ed6\u306e\u65e5\u548c\u898b\u75c5\u539f\u4f53\u3068\u306e\u540c\u6642\u611f\u67d3\u306b\u3064\u306a\u304c\u308b\u53ef\u80fd\u6027\u3092\u793a\u5506\u3057\u3066\u3044\u307e\u3059\u3002\u3053\u308c\u306f\u3001\u514d\u75ab\u6291\u5236\u60a3\u8005\u306e\u7ba1\u7406\u306b\u304a\u3044\u3066\u3001\u3088\u308a\u5e83\u7bc4\u306a\u9451\u5225\u8a3a\u65ad\u3068\u75c5\u539f\u4f53\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u306e\u91cd\u8981\u6027\u3092\u5f37\u8abf\u3057\u3066\u3044\u307e\u3059\u3002<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">4. \u8b70\u8ad6\u306f\u3042\u308b\uff1f<\/h3>\n\n\n\n<p>\u672c\u7814\u7a76\u306b\u306f\u3044\u304f\u3064\u304b\u306e\u8b70\u8ad6\u70b9\u3068\u672a\u89e3\u6c7a\u306e\u8ab2\u984c\u304c\u5b58\u5728\u3057\u307e\u3059\u3002<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u8a3a\u65ad\u7684\u30b5\u30f3\u30d7\u30ea\u30f3\u30b0\u306e\u9650\u754c<\/strong>: \u672c\u75c7\u4f8b\u3067\u306f\u5580\u75f0\u3068\u7d4c\u6c17\u7ba1\u652f\u751f\u691c\u7d44\u7e54\u304b\u3089\u75c5\u539f\u4f53\u304c\u691c\u51fa\u3055\u308c\u307e\u3057\u305f\u304c\u3001\u7279\u306b\u91cd\u75c7\u60a3\u8005\u306e\u5834\u5408\u3001\u3088\u308a\u4fb5\u8972\u7684\u306a\u751f\u691c\uff08\u4f8b\uff1a\u5916\u79d1\u7684\u80ba\u751f\u691c\uff09\u304c\u5fc5\u8981\u3068\u306a\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059\u3002\u5580\u75f0\u30b5\u30f3\u30d7\u30eb\u306e\u51e6\u7406\u65b9\u6cd5\uff08\u30ce\u30ab\u30eb\u30b8\u30a2\u306e\u5897\u6b96\u3092\u6291\u5236\u3059\u308b\u76ee\u7684\u3067\u306e\u30b7\u30e5\u30a6\u9178\u51e6\u7406\uff09\u306f\u9769\u65b0\u7684\u3067\u3057\u305f\u304c\u3001\u3059\u3079\u3066\u306e\u30b1\u30fc\u30b9\u3067\u540c\u69d8\u306b\u6709\u52b9\u304b\u3069\u3046\u304b\u306f\u3055\u3089\u306a\u308b\u691c\u8a3c\u304c\u5fc5\u8981\u3067\u3059\u3002 <\/li>\n\n\n\n<li><strong>\u30de\u30a4\u30b3\u30d0\u30af\u30c6\u30ea\u30a6\u30e0\u30fb\u30a2\u30d6\u30bb\u30c3\u30b5\u30b9\u8907\u5408\u4f53\u306e\u81e8\u5e8a\u7684\u610f\u7fa9<\/strong>: \u5580\u75f0\u304b\u3089<em>M. abscessus<\/em>\u8907\u5408\u4f53\u304c\u691c\u51fa\u3055\u308c\u305f\u3082\u306e\u306e\u3001\u521d\u671f\u6cbb\u7642\u306f\u30ce\u30ab\u30eb\u30b8\u30a2\u611f\u67d3\u306b\u7126\u70b9\u3092\u5f53\u3066\u3001<em>M. abscessus<\/em>\u611f\u67d3\u306b\u5bfe\u3059\u308b\u6cbb\u7642\u306f\u81e8\u5e8a\u53cd\u5fdc\u3092\u898b\u3066\u6c7a\u5b9a\u3059\u308b\u8a08\u753b\u3067\u3057\u305f\u3002 NTM\u306f\u80ba\u306b\u5b9a\u7740\u3059\u308b\u3060\u3051\u3067\u75c5\u539f\u6027\u3092\u793a\u3055\u306a\u3044\u5834\u5408\u304c\u3042\u308b\u305f\u3081\u3001\u771f\u306e\u611f\u67d3\u3068\u5b9a\u7740\u306e\u533a\u5225\u306f\u5e38\u306b\u8ab2\u984c\u3068\u306a\u308a\u307e\u3059\u3002  \u672c\u75c7\u4f8b\u3067\u306f\u3001<em>M. abscessus<\/em>\u304c\u81e8\u5e8a\u75c7\u72b6\u306b\u3069\u306e\u7a0b\u5ea6\u5bc4\u4e0e\u3057\u3066\u3044\u305f\u306e\u304b\u3001\u307e\u305f\u30ce\u30ab\u30eb\u30b8\u30a2\u6cbb\u7642\u306b\u3088\u3063\u3066<em>M. abscessus<\/em>\u304c\u90e8\u5206\u7684\u306b\u6291\u5236\u3055\u308c\u305f\u53ef\u80fd\u6027\u306b\u3064\u3044\u3066\u3082\u8b70\u8ad6\u306e\u4f59\u5730\u304c\u3042\u308a\u307e\u3059\u3002<\/li>\n\n\n\n<li><strong>\u6cbb\u7642\u671f\u9593\u3068\u518d\u767a\u30ea\u30b9\u30af<\/strong>: \u30ce\u30ab\u30eb\u30b8\u30a2\u75c7\u306e\u6cbb\u7642\u306f\u3001\u518d\u767a\u306e\u30ea\u30b9\u30af\u304c\u9ad8\u3044\u305f\u3081\u3001\u9577\u671f\u9593\u306b\u308f\u305f\u308b\u3053\u3068\u304c\u4e00\u822c\u7684\u3067\u3059\uff08\u5b64\u7acb\u6027\u80ba\u30ce\u30ab\u30eb\u30b8\u30a2\u75c7\u30676\uff5e12\u30f6\u6708\u3001\u64ad\u7a2e\u6027\u75be\u60a3\u3067\u5c11\u306a\u304f\u3068\u308212\u30f6\u6708\uff09\u3002 \u672c\u75c7\u4f8b\u3067\u306f12\u30f6\u6708\u9593\u306e\u7d4c\u53e3\u30c8\u30ea\u30e1\u30c8\u30d7\u30ea\u30e0-\u30b9\u30eb\u30d5\u30a1\u30e1\u30c8\u30ad\u30b5\u30be\u30fc\u30eb\u7642\u6cd5\u304c\u8a08\u753b\u3055\u308c\u307e\u3057\u305f\u304c\u3001\u9577\u671f\u7684\u306a\u6cbb\u7642\u9075\u5b88\u3068\u518d\u767a\u7387\u306b\u95a2\u3059\u308b\u30c7\u30fc\u30bf\u306f\u63d0\u793a\u3055\u308c\u3066\u3044\u307e\u305b\u3093\u3002  \u6df7\u5408\u611f\u67d3\u306e\u5834\u5408\u3001\u6cbb\u7642\u671f\u9593\u306e\u6c7a\u5b9a\u306f\u3055\u3089\u306b\u8907\u96d1\u306b\u306a\u308a\u307e\u3059\u3002<\/li>\n\n\n\n<li><strong>\u85ac\u5264\u8010\u6027\u306e\u53ef\u80fd\u6027<\/strong>: \u30ce\u30ab\u30eb\u30b8\u30a2\u7a2e\u9593\u304a\u3088\u3073\u5730\u57df\u9593\u3067\u85ac\u5264\u8010\u6027\u306b\u3070\u3089\u3064\u304d\u304c\u3042\u308b\u305f\u3081\u3001\u611f\u53d7\u6027\u8a66\u9a13\u306b\u57fa\u3065\u3044\u305f\u6297\u83cc\u85ac\u9078\u629e\u304c\u91cd\u8981\u3067\u3059\u3002 <em>M. abscessus<\/em>\u3082\u307e\u305f\u3001\u591a\u5264\u8010\u6027\u3092\u793a\u3059\u3053\u3068\u304c\u3042\u308a\u3001\u6cbb\u7642\u9078\u629e\u3092\u8907\u96d1\u306b\u3059\u308b\u53ef\u80fd\u6027\u304c\u3042\u308a\u307e\u3059\u3002  \u672c\u75c7\u4f8b\u3067\u9078\u629e\u3055\u308c\u305f\u6cbb\u7642\u85ac\u306b\u5bfe\u3059\u308b\u4e21\u75c5\u539f\u4f53\u306e\u611f\u53d7\u6027\u30d7\u30ed\u30d5\u30a1\u30a4\u30eb\u306b\u95a2\u3059\u308b\u8a73\u7d30\u306a\u30c7\u30fc\u30bf\u306f\u63d0\u4f9b\u3055\u308c\u3066\u3044\u307e\u305b\u3093\u3002<\/li>\n\n\n\n<li><strong>\u4e00\u822c\u5316\u53ef\u80fd\u6027<\/strong>: \u672c\u8ad6\u6587\u306f1\u3064\u306e\u75c7\u4f8b\u5831\u544a\u3067\u3042\u308a\u3001\u305d\u306e\u7d50\u679c\u3092\u4ed6\u306e\u60a3\u8005\u96c6\u56e3\u306b\u4e00\u822c\u5316\u3059\u308b\u969b\u306b\u306f\u6ce8\u610f\u304c\u5fc5\u8981\u3067\u3059\u3002\u305f\u3060\u3057\u3001\u7a00\u306a\u6df7\u5408\u611f\u67d3\u75c7\u306e\u8a3a\u65ad\u3068\u6cbb\u7642\u306b\u95a2\u3059\u308b\u91cd\u8981\u306a\u793a\u5506\u3092\u63d0\u4f9b\u3057\u3066\u3044\u307e\u3059\u3002<\/li>\n\n\n\n<li><strong>\u6f5c\u5728\u7684\u306a\u502b\u7406\u7684\u8003\u616e\u4e8b\u9805<\/strong>: \u60a3\u8005\u306e\u30d7\u30e9\u30a4\u30d0\u30b7\u30fc\u306f\u4fdd\u8b77\u3055\u308c\u3066\u3044\u307e\u3059\u304c\u3001\u7a00\u306a\u75c7\u4f8b\u3067\u3042\u308b\u305f\u3081\u3001\u8a73\u7d30\u306a\u75c5\u6b74\u3084\u753b\u50cf\u60c5\u5831\u304c\u60a3\u8005\u8b58\u5225\u306e\u30ea\u30b9\u30af\u3092\u3082\u305f\u3089\u3059\u53ef\u80fd\u6027\u3082\u8003\u616e\u3059\u3079\u304d\u3067\u3059\u3002<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">5. \u6280\u8853\u3084\u624b\u6cd5\u306e\u30ad\u30e2\u306f\u3069\u3053\uff1f<\/h3>\n\n\n\n<p>\u672c\u75c7\u4f8b\u306b\u304a\u3051\u308b\u6280\u8853\u3084\u624b\u6cd5\u306e\u30ad\u30e2\u306f\u3001\u7a00\u306a\u6df7\u5408\u611f\u67d3\u75c7\u3092\u6b63\u78ba\u306b\u8a3a\u65ad\u3059\u308b\u305f\u3081\u306b\u3001\u6a19\u6e96\u7684\u306a\u5fae\u751f\u7269\u5b66\u7684\u691c\u67fb\u306b\u52a0\u3048\u3066\u3001\u7279\u5b9a\u306e\u5fae\u751f\u7269\u306e\u5897\u6b96\u7279\u6027\u3092\u8003\u616e\u3057\u305f\u57f9\u990a\u65b9\u6cd5\u3092\u7d44\u307f\u5408\u308f\u305b\u305f\u70b9\u306b\u3042\u308a\u307e\u3059\u3002<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u5fae\u751f\u7269\u5b66\u7684\u691c\u67fb\u306e\u6bb5\u968e\u7684\u30a2\u30d7\u30ed\u30fc\u30c1<\/strong>:\n<ul class=\"wp-block-list\">\n<li><strong>\u30b0\u30e9\u30e0\u67d3\u8272\u3068\u5909\u6cd5\u6297\u9178\u83cc\u67d3\u8272<\/strong>: \u60a3\u8005\u306e\u5580\u75f0\u304b\u3089\u30b0\u30e9\u30e0\u967d\u6027\u687f\u83cc\u304c\u691c\u51fa\u3055\u308c\u305f\u6642\u70b9\u3067\u3001\u30ce\u30ab\u30eb\u30b8\u30a2\u3068\u30a2\u30af\u30c1\u30ce\u30df\u30bb\u30b9\u3068\u3044\u3046\u5f62\u614b\u5b66\u7684\u306b\u985e\u4f3c\u3057\u305f2\u3064\u306e\u75c5\u539f\u4f53\u304c\u9451\u5225\u8a3a\u65ad\u306b\u6319\u304c\u308a\u307e\u3057\u305f\u3002\u3053\u3053\u3067\u3001\u5909\u6cd5\u6297\u9178\u83cc\u67d3\u8272\u3092\u7528\u3044\u3066\u3001\u30ce\u30ab\u30eb\u30b8\u30a2\u304c\u7523\u751f\u3059\u308b\u5fae\u91cf\u306e\u30df\u30b3\u30fc\u30eb\u9178\u3092\u5229\u7528\u3057\u3001\u8d64\u30d4\u30f3\u30af\u8272\u306b\u67d3\u8272\u3055\u308c\u308b\u30ce\u30ab\u30eb\u30b8\u30a2\u3068\u3001\u67d3\u8272\u3055\u308c\u306a\u3044\u30a2\u30af\u30c1\u30ce\u30df\u30bb\u30b9\u3092\u9451\u5225\u3057\u305f\u70b9\u304c\u91cd\u8981\u3067\u3059\u3002  \u3053\u308c\u306f\u8fc5\u901f\u306a\u9451\u5225\u8a3a\u65ad\u306b\u8ca2\u732e\u3057\u307e\u3057\u305f\u3002<\/li>\n\n\n\n<li><strong>\u30aa\u30fc\u30e9\u30df\u30f3-\u30ed\u30fc\u30c0\u30df\u30f3\u86cd\u5149\u67d3\u8272<\/strong>: \u4e88\u60f3\u5916\u306b\u77ed\u3044\u6297\u9178\u83cc\u304c\u691c\u51fa\u3055\u308c\u305f\u3053\u3068\u3067\u3001\u30ce\u30ab\u30eb\u30b8\u30a2\u3068\u306f\u7570\u306a\u308b\u30de\u30a4\u30b3\u30d0\u30af\u30c6\u30ea\u30a2\u306e\u5b58\u5728\u304c\u5f37\u304f\u793a\u5506\u3055\u308c\u307e\u3057\u305f\u3002  \u3053\u306e\u6642\u70b9\u3067\u3001\u5358\u4e00\u306e\u611f\u67d3\u75c7\u3067\u306f\u306a\u304f\u6df7\u5408\u611f\u67d3\u306e\u53ef\u80fd\u6027\u304c\u6d6e\u4e0a\u3057\u307e\u3057\u305f\u3002<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>\u9078\u629e\u7684\u57f9\u990a\u306b\u3088\u308b\u75c5\u539f\u4f53\u5206\u96e2<\/strong>:\n<ul class=\"wp-block-list\">\n<li><strong>\u901a\u5e38\u57f9\u990a\u3068\u8131\u6c5a\u67d3\u51e6\u7406<\/strong>: \u30ce\u30ab\u30eb\u30b8\u30a2\u3084\u30de\u30a4\u30b3\u30d0\u30af\u30c6\u30ea\u30a2\u306f\u3001\u4e00\u822c\u7684\u306a\u7d30\u83cc\u3088\u308a\u3082\u5897\u6b96\u304c\u9045\u304f\u3001\u901a\u5e38\u306e\u7d30\u83cc\u53e2\u306b\u3088\u3063\u3066\u5bb9\u6613\u306b\u5897\u6b96\u304c\u963b\u5bb3\u3055\u308c\u308b\u3068\u3044\u3046\u7279\u6027\u304c\u3042\u308a\u307e\u3059\u3002\u3053\u306e\u305f\u3081\u3001\u5580\u75f0\u306a\u3069\u306e\u975e\u7121\u83cc\u691c\u4f53\u306f\u3001\u901a\u5e38\u306e\u7d30\u83cc\u306e\u5897\u6b96\u3092\u6291\u3048\u308b\u305f\u3081\u306b\u6c34\u9178\u5316\u30ca\u30c8\u30ea\u30a6\u30e0\u3067\u8131\u6c5a\u67d3\u51e6\u7406\u3055\u308c\u307e\u3059\u3002 \u3053\u308c\u306b\u3088\u308a\u3001<em>Nocardia farcinica<\/em>\u8907\u5408\u4f53\u304c\u7d14\u7c8b\u57f9\u990a\u3067\u5f97\u3089\u308c\u307e\u3057\u305f\u3002 <\/li>\n\n\n\n<li><strong>\u30ce\u30ab\u30eb\u30b8\u30a2\u6291\u5236\u57f9\u990a<\/strong>: \u6700\u3082\u91cd\u8981\u306a\u6280\u8853\u7684\u30d6\u30ec\u30fc\u30af\u30b9\u30eb\u30fc\u306f\u3001\u30ce\u30ab\u30eb\u30b8\u30a2\u304c\u30de\u30a4\u30b3\u30d0\u30af\u30c6\u30ea\u30a2\u306e\u5897\u6b96\u3092\u6291\u5236\u3059\u308b\u53ef\u80fd\u6027\u3092\u8003\u616e\u3057\u3001\u30b7\u30e5\u30a6\u9178\u3068\u3044\u3046\u3088\u308a\u5f37\u529b\u306a\u51e6\u7406\u3067\u30ce\u30ab\u30eb\u30b8\u30a2\u3092\u6bba\u83cc\u3057\u305f\u4e0a\u3067\u5580\u75f0\u3092\u57f9\u990a\u3057\u305f\u70b9\u3067\u3059\u3002 \u3053\u306e\u5de5\u592b\u306b\u3088\u308a\u3001<em>Mycobacterium abscessus<\/em>\u8907\u5408\u4f53\u304c\u7d14\u7c8b\u57f9\u990a\u3067\u5f97\u3089\u308c\u307e\u3057\u305f\u3002  \u3053\u306e\u624b\u6cd5\u304c\u306a\u3051\u308c\u3070\u3001<em>M. abscessus<\/em>\u611f\u67d3\u306f\u898b\u904e\u3054\u3055\u308c\u3066\u3044\u305f\u53ef\u80fd\u6027\u304c\u9ad8\u304f\u3001\u6b63\u78ba\u306a\u8a3a\u65ad\u3068\u9069\u5207\u306a\u6cbb\u7642\u306e\u6a5f\u4f1a\u3092\u9038\u3057\u3066\u3044\u305f\u3067\u3057\u3087\u3046\u3002<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>\u6cbb\u7642\u6226\u7565\u3078\u306e\u5fdc\u7528<\/strong>: \u4e21\u65b9\u306e\u75c5\u539f\u4f53\u3092\u7279\u5b9a\u3057\u305f\u3053\u3068\u3067\u3001\u305d\u308c\u305e\u308c\u306e\u611f\u53d7\u6027\u30d7\u30ed\u30d5\u30a1\u30a4\u30eb\u3092\u8003\u616e\u3057\u3001\u30c8\u30ea\u30e1\u30c8\u30d7\u30ea\u30e0-\u30b9\u30eb\u30d5\u30a1\u30e1\u30c8\u30ad\u30b5\u30be\u30fc\u30eb\u3068\u30a4\u30df\u30da\u30cd\u30e0\u3068\u3044\u3046\u4f75\u7528\u7642\u6cd5\u3092\u9078\u629e\u3067\u304d\u307e\u3057\u305f\u3002 \u3053\u306e\u4f75\u7528\u7642\u6cd5\u306f\u3001\u30ce\u30ab\u30eb\u30b8\u30a2\u75c7\u306e\u91cd\u75c7\u4f8b\u306b\u63a8\u5968\u3055\u308c\u308b\u3082\u306e\u3067\u3042\u308a  \u3001<em>M. abscessus<\/em>\u306b\u5bfe\u3057\u3066\u3082\u90e8\u5206\u7684\u306b\u6709\u52b9\u3067\u3042\u308b\u53ef\u80fd\u6027\u3092\u8003\u616e\u3059\u308b\u3053\u3068\u3067\u3001\u4e0d\u9069\u5207\u306a\u5358\u5264\u7642\u6cd5\u3092\u907f\u3051\u3001\u8010\u6027\u83cc\u306e\u51fa\u73fe\u30ea\u30b9\u30af\u3092\u4f4e\u6e1b\u3057\u307e\u3057\u305f\u3002<\/li>\n<\/ul>\n\n\n\n<p>\u3053\u308c\u3089\u306e\u8a3a\u65ad\u624b\u6cd5\u306e\u7d44\u307f\u5408\u308f\u305b\u3001\u7279\u306b\u30ce\u30ab\u30eb\u30b8\u30a2\u306e\u5897\u6b96\u3092\u6291\u5236\u3059\u308b\u7279\u5b9a\u306e\u57f9\u990a\u6761\u4ef6\u3092\u7528\u3044\u308b\u3068\u3044\u3046\u7740\u60f3\u304c\u3001\u672c\u75c7\u4f8b\u306e\u6b63\u78ba\u306a\u8a3a\u65ad\u3068\u6cbb\u7642\u306b\u4e0d\u53ef\u6b20\u306a\u6280\u8853\u7684\u30ad\u30e2\u3067\u3042\u308a\u3001\u4ed6\u306e\u8907\u96d1\u306a\u6df7\u5408\u611f\u67d3\u75c7\u306e\u8a3a\u65ad\u306b\u3082\u5fdc\u7528\u53ef\u80fd\u306a\u77e5\u898b\u3092\u63d0\u4f9b\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">6. \u6b21\u306b\u8aad\u3080\u3079\u304d\u8ad6\u6587\u306f\uff1f<\/h3>\n\n\n\n<p>\u672c\u7814\u7a76\u306e\u6587\u8108\u3092\u3055\u3089\u306b\u6df1\u304f\u7406\u89e3\u3057\u3001\u95a2\u9023\u3059\u308b\u7814\u7a76\u9818\u57df\u306e\u6700\u65b0\u52d5\u5411\u3092\u628a\u63e1\u3059\u308b\u305f\u3081\u306b\u306f\u3001\u4ee5\u4e0b\u306e\u8ad6\u6587\u304c\u63a8\u5968\u3055\u308c\u307e\u3059\u3002<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u30ce\u30ab\u30eb\u30b8\u30a2\u75c7\u306b\u95a2\u3059\u308b\u7dcf\u8aac<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Wilson, J. W. (2012). &#8220;Nocardiosis: updates and clinical overview.&#8221; <em>Mayo Clinic Proceedings<\/em>, 87(4), 403-407. \n<ul class=\"wp-block-list\">\n<li>\u30ce\u30ab\u30eb\u30b8\u30a2\u75c7\u306e\u8a3a\u65ad\u3001\u6cbb\u7642\u3001\u75ab\u5b66\u306b\u95a2\u3059\u308b\u5305\u62ec\u7684\u306a\u30ec\u30d3\u30e5\u30fc\u3067\u3042\u308a\u3001\u672c\u75c7\u4f8b\u306e\u80cc\u666f\u77e5\u8b58\u3092\u6df1\u3081\u308b\u306e\u306b\u5f79\u7acb\u3061\u307e\u3059\u3002\u7279\u306b\u3001\u514d\u75ab\u4e0d\u5168\u60a3\u8005\u306b\u304a\u3051\u308b\u30ce\u30ab\u30eb\u30b8\u30a2\u611f\u67d3\u75c7\u306e\u81e8\u5e8a\u50cf\u306b\u3064\u3044\u3066\u7406\u89e3\u3092\u6df1\u3081\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u3059\u3002<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Traxler, R. M., Bell, M. E., Lasker, B., Headd, B., Shieh, W.-J., &amp; McQuiston, J. R. (2022). &#8220;Updated Review on Nocardia Species: 2006-2021.&#8221; <em>Clinical Microbiology Reviews<\/em>, 35(4), e00027-21. \n<ul class=\"wp-block-list\">\n<li>\u30ce\u30ab\u30eb\u30b8\u30a2\u5c5e\u306e\u6700\u65b0\u306e\u5206\u985e\u3001\u75c5\u539f\u6027\u3001\u8a3a\u65ad\u3001\u6cbb\u7642\u306b\u95a2\u3059\u308b\u5305\u62ec\u7684\u306a\u30ec\u30d3\u30e5\u30fc\u3067\u3059\u3002\u8fd1\u5e74\u767a\u898b\u3055\u308c\u305f\u65b0\u3057\u3044\u30ce\u30ab\u30eb\u30b8\u30a2\u7a2e\u3084\u3001\u85ac\u5264\u611f\u53d7\u6027\u306e\u30c8\u30ec\u30f3\u30c9\u306b\u3064\u3044\u3066\u3082\u8a00\u53ca\u304c\u3042\u308b\u53ef\u80fd\u6027\u304c\u3042\u308a\u3001\u3088\u308a\u8a73\u7d30\u306a\u60c5\u5831\u3092\u5f97\u3089\u308c\u307e\u3059\u3002<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>\u975e\u7d50\u6838\u6027\u6297\u9178\u83cc\uff08NTM\uff09\u80ba\u75be\u60a3\u306e\u8a3a\u65ad\u3068\u6cbb\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Daley, C. L., Iaccarino, J. M., Lange, C., et al. (2020). &#8220;Treatment of Nontuberculous Mycobacterial Pulmonary Disease: An Official ATS\/ERS\/ESCMID\/IDSA Clinical Practice Guideline.&#8221; <em>Clinical Infectious Diseases<\/em>, 71(4), e1-e36. \n<ul class=\"wp-block-list\">\n<li>NTM\u80ba\u75be\u60a3\u306e\u8a3a\u65ad\u57fa\u6e96\u3001\u6cbb\u7642\u30a2\u30eb\u30b4\u30ea\u30ba\u30e0\u3001\u85ac\u5264\u611f\u53d7\u6027\u691c\u67fb\u306e\u91cd\u8981\u6027\u306a\u3069\u3001\u81e8\u5e8a\u533b\u304cNTM\u611f\u67d3\u75c7\u3092\u7ba1\u7406\u3059\u308b\u305f\u3081\u306e\u8a73\u7d30\u306a\u6307\u91dd\u304c\u793a\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u672c\u75c7\u4f8b\u306b\u304a\u3051\u308b<em>M. abscessus<\/em>\u8907\u5408\u4f53\u306e\u81e8\u5e8a\u7684\u610f\u7fa9\u3068\u6cbb\u7642\u65b9\u91dd\u3092\u7406\u89e3\u3059\u308b\u4e0a\u3067\u4e0d\u53ef\u6b20\u3067\u3059\u3002<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>\u514d\u75ab\u4e0d\u5168\u60a3\u8005\u306b\u304a\u3051\u308b\u65e5\u548c\u898b\u611f\u67d3\u75c7<\/strong>:\n<ul class=\"wp-block-list\">\n<li>\u3053\u306e\u5206\u91ce\u306e\u4e00\u822c\u7684\u306a\u30ec\u30d3\u30e5\u30fc\u8ad6\u6587\u3084\u3001\u7279\u5b9a\u306e\u514d\u75ab\u6291\u5236\u72b6\u614b\uff08\u4f8b\uff1a\u9577\u671f\u30b0\u30eb\u30b3\u30b3\u30eb\u30c1\u30b3\u30a4\u30c9\u4f7f\u7528\u3001\u751f\u7269\u5b66\u7684\u88fd\u5264\u306e\u4f7f\u7528\uff09\u306b\u304a\u3051\u308b\u611f\u67d3\u75c7\u30ea\u30b9\u30af\u306b\u95a2\u3059\u308b\u8ad6\u6587\u3092\u8aad\u3080\u3053\u3068\u3067\u3001\u672c\u75c7\u4f8b\u306e\u60a3\u8005\u80cc\u666f\u3092\u3088\u308a\u6df1\u304f\u7406\u89e3\u3067\u304d\u307e\u3059\u3002 dupilumab\u306e\u4f7f\u7528\u304c\u5bc4\u751f\u866b\u611f\u67d3\u75c7\u3078\u306e\u611f\u53d7\u6027\u3092\u9ad8\u3081\u308b\u53ef\u80fd\u6027\u306b\u3064\u3044\u3066\u3082\u8a00\u53ca\u3055\u308c\u3066\u3044\u307e\u3059\u304c  \u3001\u4ed6\u306e\u514d\u75ab\u6291\u5236\u5264\u304c\u5f15\u304d\u8d77\u3053\u3059\u65e5\u548c\u898b\u611f\u67d3\u75c7\u5168\u822c\u306b\u3064\u3044\u3066\u5b66\u3076\u3053\u3068\u306f\u3001\u9451\u5225\u8a3a\u65ad\u80fd\u529b\u306e\u5411\u4e0a\u306b\u7e4b\u304c\u308a\u307e\u3059\u3002<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>\u80ba\u306e\u7a7a\u6d1e\u6027\u75c5\u5909\u3068\u816b\u7624\u6027\u75c5\u5909\u306e\u753b\u50cf\u8a3a\u65ad<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Duong, T. B., Ceglar, S., Reaume, M., &amp; Lee, C. (2020). &#8220;Imaging Approach to Cavitary Lung Disease.&#8221; <em>Annals of the American Thoracic Society<\/em>, 17(3), 367-371. <\/li>\n\n\n\n<li>Kanne, J. P., Yandow, D. R., Mohammed, T. L., &amp; Meyer, C. A. (2011). &#8220;CT findings of pulmonary nocardiosis.&#8221; <em>AJR American Journal of Roentgenology<\/em>, 197(2), W266-W272. \n<ul class=\"wp-block-list\">\n<li>\u3053\u308c\u3089\u306e\u8ad6\u6587\u306f\u3001\u80ba\u306e\u7a7a\u6d1e\u6027\u75c5\u5909\u3084\u816b\u7624\u6027\u75c5\u5909\u306e\u9451\u5225\u8a3a\u65ad\u306b\u5f79\u7acb\u3064\u753b\u50cf\u6240\u898b\u306b\u7126\u70b9\u3092\u5f53\u3066\u3066\u3044\u307e\u3059\u3002\u30ce\u30ab\u30eb\u30b8\u30a2\u75c7\u306eCT\u6240\u898b\u306b\u95a2\u3059\u308b\u8a73\u7d30\u306f\u3001\u8a3a\u65ad\u63a8\u8ad6\u306e\u904e\u7a0b\u3092\u7406\u89e3\u3059\u308b\u4e0a\u3067\u6709\u76ca\u3067\u3059\u3002<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-audio\"><audio controls src=\"https:\/\/plaza.umin.ac.jp\/~OIO\/wp-content\/uploads\/2025\/07\/a96a624dc4a4f8c1f5092b9593496259.mp3\"><\/audio><\/figure>\n\n\n\n<p><\/p>\n<div class=\"powerpress_player\" id=\"powerpress_player_6700\"><audio class=\"wp-audio-shortcode\" id=\"audio-3844-1\" preload=\"none\" style=\"width: 100%;\" controls=\"controls\"><source type=\"audio\/mpeg\" src=\"https:\/\/media.blubrry.com\/3955429\/plaza.umin.ac.jp\/~OIO\/wp-content\/uploads\/2025\/07\/a96a624dc4a4f8c1f5092b9593496259.mp3?_=1\" \/><a href=\"https:\/\/media.blubrry.com\/3955429\/plaza.umin.ac.jp\/~OIO\/wp-content\/uploads\/2025\/07\/a96a624dc4a4f8c1f5092b9593496259.mp3\">https:\/\/media.blubrry.com\/3955429\/plaza.umin.ac.jp\/~OIO\/wp-content\/uploads\/2025\/07\/a96a624dc4a4f8c1f5092b9593496259.mp3<\/a><\/audio><\/div><p class=\"powerpress_links powerpress_links_mp3\" style=\"margin-bottom: 1px !important;\">Podcast: <a href=\"https:\/\/media.blubrry.com\/3955429\/plaza.umin.ac.jp\/~OIO\/wp-content\/uploads\/2025\/07\/a96a624dc4a4f8c1f5092b9593496259.mp3\" class=\"powerpress_link_pinw\" target=\"_blank\" title=\"Play in new window\" onclick=\"return powerpress_pinw('https:\/\/plaza.umin.ac.jp\/~OIO\/?powerpress_pinw=3844-podcast');\" rel=\"nofollow\">Play in new window<\/a> | <a href=\"https:\/\/media.blubrry.com\/3955429\/plaza.umin.ac.jp\/~OIO\/wp-content\/uploads\/2025\/07\/a96a624dc4a4f8c1f5092b9593496259.mp3\" class=\"powerpress_link_d\" title=\"Download\" rel=\"nofollow\" download=\"a96a624dc4a4f8c1f5092b9593496259.mp3\">Download<\/a><\/p><!--powerpress_player-->","protected":false},"excerpt":{"rendered":"<p>Case 21-2025: A 75-Year-Old Man with Cough, Dyspnea, and Hypoxemia \u8868\u984c\u306e\u8ad6\u6587\u3092AI\u3068\u3068\u3082\u306b\u8aad\u307f\u8fbc\u307f\u307e\u3057\u305f \uff08\u672c\u8a18\u4e8b\u306f\u5143\u6587\u732e\u3092\u898b\u306a\u304c\u3089\u8aad\u3093\u3067\u3044\u305f\u3060\u304f\u524d\u63d0\u3067&#8230;<\/p>\n","protected":false},"author":1,"featured_media":3848,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[20],"tags":[],"class_list":["post-3844","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-podcast"],"jetpack_featured_media_url":"https:\/\/plaza.umin.ac.jp\/~OIO\/wp-content\/uploads\/2025\/07\/A-bright-and-cheerful-illustration-in-the-same-style-as-a-medical-education-website-showing-a-resea.png","jetpack_shortlink":"https:\/\/wp.me\/p9b6zl-100","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/plaza.umin.ac.jp\/~OIO\/index.php?rest_route=\/wp\/v2\/posts\/3844","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/plaza.umin.ac.jp\/~OIO\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/plaza.umin.ac.jp\/~OIO\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/~OIO\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/~OIO\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3844"}],"version-history":[{"count":4,"href":"https:\/\/plaza.umin.ac.jp\/~OIO\/index.php?rest_route=\/wp\/v2\/posts\/3844\/revisions"}],"predecessor-version":[{"id":3851,"href":"https:\/\/plaza.umin.ac.jp\/~OIO\/index.php?rest_route=\/wp\/v2\/posts\/3844\/revisions\/3851"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/~OIO\/index.php?rest_route=\/wp\/v2\/media\/3848"}],"wp:attachment":[{"href":"https:\/\/plaza.umin.ac.jp\/~OIO\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3844"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/~OIO\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3844"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/~OIO\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3844"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}