nontuberculous%20mycobacterial%20disease
NONTUBERCULOUS MYCOBACTERIAL DISEASE
Nontuberculous mycobacteria are ubiquitous and are usually found in soil, natural and treated water sources. They are relatively uncommon cause of pulmonary disease and likely to cause disseminated disease.
May cause both asymptomatic infection and symptomatic disease in humans.
There is no evidence of animal-to-human or human-to-human transmission in immunocompetent hosts.
Nontuberculous mycobacterial pulmonary disease is a generally slowly progressive infection.
Signs and symptoms are generally nonspecific.

Nontuberculous%20mycobacterial%20disease Signs and Symptoms

Introduction

  • Nontuberculous mycobacterial (NTM) pulmonary diseases are ubiquitous & are usually found in soil, natural & treated water sources
    • Relatively uncommon cause of pulmonary disease
    • Likely to cause disseminated disease except Mycobacterium kansasii which causes lung infection w/o dissemination among HIV-coinfected patients w/ low CD4 counts
  • May cause both asymptomatic infection & symptomatic disease in humans
  • There is no evidence of animal-to-human or human-to-human transmission in immunocompetent hosts
  • NTM pulmonary disease is a generally slowly progressive infection

Etiology

  • M avium complex (MAC) is the most common NTM species causing pulmonary disease in the US
    • Includes at least 2 mycobacterial species: M avium & M intracellulare
    • M intracellulare is the more common respiratory pathogen
    • Commonly found in indoor water systems, pools & hot tubs
  • M kansasii & M abscessus are the 2nd & 3rd most common pulmonary pathogen, respectively

Signs and Symptoms

  • Generally nonspecific
  • Chronic or recurring cough w/ sputum production
  • Dyspnea, chest pain
  • Fatigue, malaise, weightt loss, fever, hemoptysis
  • May be complicated by symptoms caused by coexisting lung diseases

Risk Factors

  • Hot tub exposure
  • Older men who are smokers, older women w/ no smoking history
  • Excessive alcohol use
  • Co-existing illnesses: chronic obstructive pulmonary disease (COPD), cystic fibrosis, pneumoconiosis, prior tuberculosis (TB), esophageal motility disorders, pulmonary alveolar proteinosis, malignancy
  • There is an association between bronchiectasis, nodular NTM pulmonary disease & specific body type especially postmenopausal women (eg pectus excavatum, scoliosis, mitral valve prolapse, joint hypermobility)
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Respirology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Pearl Toh, 5 days ago
Early and sustained treatments with simplified regimen are the key to achieving good asthma control, said experts during a presentation at the ERS 2020 Congress.
Pearl Toh, 18 Sep 2020
Gefapixant, a first-in-class non-narcotic, oral P2X3 receptor antagonist, significantly reduces cough frequency in patients with refractory or unexplained chronic cough, according to two COUGH* studies presented at ERS 2020.
Roshini Claire Anthony, 3 days ago

Treatment with the DPP 1* inhibitor brensocatib prolonged time to exacerbation and reduced exacerbation rates in patients with non-cystic fibrosis bronchiectasis, according to the phase II WILLOW** study presented at ERS 2020.

Pearl Toh, 18 Jan 2020
Almost three-quarters of adverse events (AEs) related to medication errors in over-the-counter (OTC) cough and cold medications (CCMs) for paediatrics required evaluation by healthcare facility and majority of the cases were due to dosing errors, a surveillance study has found, highlighting the need for interventions to mitigate medication errors.