Pulmonary non-tuberculous mycobacterial infection
Updates to Article Attributes
Pulmonary non-tuberculous mycobacterial (NTM) infection refers to pulmonary infection caused by one of the large number (at least 150) mycobacterial species other than Mycobacterium tuberculosis. However, certain species are much more common than others.
Clinical presentation
Some patients are relatively asymptomatic. However, most have a combination of respiratory and systemic features similar to tuberculosis;
- chronic cough
- shortness of breath on exertion
-
hemoptysishaemoptysis - low-grade fever
- night sweats
- fatigue
- weight loss
Pathology
As with M. tuberculosis NTMs commonly cause pulmonary infection.
These organisms include:
- Mycobacterium avium-intracellulare: ~60% (on bronchial secretions)
- Mycobacterium kansasii: ~25%
- Mycobacterium fortuitum
- Mycobacteriumgordonae
- Mycobacterium szulgai
- Mycobacterium scrofulaceum / Mycobacterium parascrofulaceum
- Mycobacterium xenopi
-
Mycobacterium chelonae: pulmonary
mycobacteriumMycobacterium chelonae infection - Mycobacterium simiae
-
Mycobacterium abscesssus: pulmonary
mycobacteriumMycobacterium abscessus infection 2
Risk factors
The organisms have a predilection for individuals with pre-existing chronic obstructive pulmonary disease, with debilitating illnesses or various forms of immunocompromise.
Older age and tall slim Caucasian females seem to be more susceptible.
Gastro-esophageal-oesophageal reflux disease (GORD)
Associations
There may be an association achalasia of gastric cardia and M. fortuitum/chelonae infection.
Treatment and prognosis
Detailed guidelines on the management approach can be found in reference 12.are available 12. The general principles are;Multidrug:
-
multidrug therapy according to the sensitivities of the organisms
.Treatment -
treatment for
atleastat least 12 months.Specialist -
specialist follow-up to monitor compliance and drug side effects
.
-<li>hemoptysis</li>- +<li><a title="Haemoptysis" href="/articles/haemoptysis-1">haemoptysis</a></li>
-<li><em>Mycobacterium scrofulaceum / <em>Mycobacterium parascrofulaceum</em></em></li>- +<li><em>Mycobacterium scrofulaceum / <em>Mycobacterium parascrofulaceum </em></em></li>
-<em>Mycobacterium chelonae</em>: <a href="/articles/pulmonary-mycobacterium-chelonae-infection-1">pulmonary mycobacterium chelonae infection</a>- +<em>Mycobacterium chelonae</em>: <a href="/articles/pulmonary-mycobacterium-chelonae-infection-1">pulmonary Mycobacterium chelonae infection</a>
-<em>Mycobacterium abscesssus</em>: <a href="/articles/pulmonary-mycobacterium-abscessus-infection">pulmonary mycobacterium abscessus infection</a> <sup>2</sup>- +<em>Mycobacterium abscesssus</em>: <a href="/articles/pulmonary-mycobacterium-abscessus-infection">pulmonary Mycobacterium abscessus infection</a> <sup>2</sup>
-</ul><h5>Risk factors</h5><p>The organisms have a predilection for individuals with pre-existing <a href="/articles/chronic-obstructive-pulmonary-disease-1">chronic obstructive pulmonary disease</a>, with debilitating illnesses or various forms of immunocompromise.</p><p>Older age and tall slim Caucasian females seem to be more susceptible.</p><p><a href="/articles/gastro-oesophageal-reflux-disease">Gastro-esophageal reflux disease (GORD)</a></p><h5>Associations</h5><p>There may be an association achalasia of gastric cardia and <em>M. fortuitum</em>/<em>chelonae </em>infection.</p><h4>Treatment and prognosis</h4><p>Detailed guidelines on the management approach can be found in reference 12.<br>The general principles are;<br>Multidrug therapy according to the sensitivities of the organisms.<br>Treatment for atleast 12 months.<br>Specialist follow-up to monitor compliance and drug side effects.<br> </p>- +</ul><h5>Risk factors</h5><p>The organisms have a predilection for individuals with pre-existing <a href="/articles/chronic-obstructive-pulmonary-disease-1">chronic obstructive pulmonary disease</a>, with debilitating illnesses or various forms of immunocompromise.</p><p>Older age and tall slim Caucasian females seem to be more susceptible.</p><p><a href="/articles/gastro-oesophageal-reflux-disease">Gastro-oesophageal reflux disease (GORD)</a></p><h5>Associations</h5><p>There may be an association achalasia of gastric cardia and <em>M. fortuitum</em>/<em>chelonae </em>infection.</p><h4>Treatment and prognosis</h4><p>Detailed guidelines on the management approach are available <sup>12</sup>. The general principles are:</p><ul>
- +<li>multidrug therapy according to the sensitivities of the organisms</li>
- +<li>treatment for at least 12 months</li>
- +<li>specialist follow-up to monitor compliance and drug side effects<br> </li>
- +</ul>