Pulmonary non-tuberculous mycobacterial infection

“Ladies
don’t cough”: Lady Windermere syndrome. Frontal radiogram shows small, ill-defined opacities in the middle and upper lobe. Air bronchogram is depicted in the right middle lobe.
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“Ladies
don’t cough”: Lady Windermere syndrome. CT axial image shows cylindrical bronchiectasis and partial volume loss in the middle lobe.
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“Ladies
don’t cough”: Lady Windermere syndrome. Axial CT image in the posterior segment of the right upper lobe shows bronchial wall thickening and multiple small nodules.
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“Ladies
don’t cough”: Lady Windermere syndrome. Axial CT showing in detail a) branching centrilobular nodules (arrow) in keeping with tree-in-bud pattern and b) bronchial wall thickening (arrow) and multiple small nodules (arrowhead).
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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:

Risk factors
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:
und weiter:
Assoziationen und Differentialdiagnosen zu Nichttuberkulöse Mykobakteriose Lunge:
pulmonary
Mycobacterium avium complex infection
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Lady
Windermere Syndrom
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Nichttuberkulöse
Mycobakteriose
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