Nichttuberkulöse Mykobakteriose Lunge
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 that may resemble tuberculosis:
- chronic cough
- shortness of breath on exertion
- hemoptysis
- low-grade fever
- night sweats
- fatigue
- weight loss
Pathology
As with M. tuberculosis, NTMs commonly cause pulmonary infection. More than 150 species of NTM species are identified some of which have been can cause infections in humans. These include:
- Mycobacterium avium-intracellulare: ~60% (on bronchial secretions)
- Mycobacterium kansasii: ~25%
- Mycobacterium fortuitum
- Mycobacterium malmoense: pulmonary Mycobacterium malmoense infection
- Mycobacteriumgordonae
- Mycobacterium szulgai
- Mycobacterium scrofulaceum / Mycobacterium parascrofulaceum
- Mycobacterium xenopi
- Mycobacterium chelonae: pulmonary Mycobacterium chelonae infection
- Mycobacterium simiae
- Mycobacterium palustre
- Mycobacterium kumamotonense
- Mycobacterium kubicae
- Mycobacterium morokaense
- Mycobacterium abscessus: pulmonary Mycobacterium abscessus infection
Risk factors
- chronic lung diseases such as
- older age and tall slim Caucasian females seem to be more susceptible
- immunodeficiency states
- gastro-esophageal reflux disease (GERD)
Associations
There may be an association between achalasia of gastric cardia and M. fortuitum/chelonae infection.
Treatment and prognosis
Detailed guidelines on the management approach are available . The general principles are:
- multidrug therapy according to the sensitivities of the organisms
- treatment for at least 12 months
- specialist follow-up to monitor compliance and drug side effects
Siehe auch:
- Bronchiektasen
- pulmonary Mycobacterium avium complex infection
- Lady Windermere Syndrom
- Nichttuberkulöse Mycobakteriose
- Mycobacterium tuberculosis pulmonary infection