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Infection of the bones and joints
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Non-tuberculous mycobacteria are ubiquitous environmental organisms. They are best recognised as agents of disease in patients with underlying immunocompromise (including HIV, diabetes and organ transplantation), or other risk factors for introduction of infection (such as penetrating trauma or the presence of a prosthesis). However, they may occasionally also cause infection in hosts without obvious risk factors.
Microbiology
Published in Jonathan M. Fishman, Vivian A. Elwell, Rajat Chowdhury, OSCEs for the MRCS Part B, 2017
Jonathan M. Fishman, Vivian A. Elwell, Rajat Chowdhury
Non-tuberculous mycobacteria – May be treated either with surgical excision (lymphadenectomy) or prolonged courses of antibiotics (e.g. clarithromycin, rifampicin, ethambutol). Incision and drainage is contraindicated as it may lead to a chronically discharging sinus.
Hypersensitivity pneumonitis
Published in Muhunthan Thillai, David R Moller, Keith C Meyer, Clinical Handbook of Interstitial Lung Disease, 2017
Christine Fiddler, Helen Parfrey
There is a growing body of evidence to support a role for mycobacterial species in HP. Mycobacterium avium complex has been associated with hot tub lung (62) and Mycobacterium immunogenum contaminating metalworking fluid aerosols with machine operator's lung in automobile manufacturing and the aerospace industry (63,64). Unlike other bacteria, nontuberculous mycobacteria are capable of surviving such environments due to their thermotolerance and disinfectant resistance. Certain low molecular weight chemicals may cause HP. For example, isocyanates, used for the production of polyurethane polymers in the manufacture of polyurethane foams, paints and plastics, are not antigenic by themselves, but may combine with host proteins, such as albumin, to form haptens (65).
Nontuberculous mycobacterial infections in a Danish region between 2011 and 2021: evaluation of trends in diagnostic codes
Published in Infectious Diseases, 2023
Victor Naestholt Dahl, Andreas Fløe, Christian Wejse
Across the world, incidences and prevalences of nontuberculous mycobacteria (NTM), mainly pulmonary, are increasing [1]. In contrast to the genetically-related Mycobacterium tuberculosis, there is no routine surveillance or notification system for NTM infection in most settings. In Denmark, only a few epidemiological studies of NTM exist [2,3]. These studies have not been able to confirm an increasing trend of NTM although presenting comprehensive culture-based data. Unfortunately, microbiological data alone are not able to distinguish between transient findings (‘colonization’) and disease. In Denmark, larger studies of patients diagnosed with NTM disease (i.e. patients treated with antibiotics due to clinically relevant symptoms and radiological findings) are lacking [1]. There is only one small and old questionnaire-based study of 104 patients covering a period of two years [4]. Although including a considerable risk of coding errors and underestimation, the International Classification of Diseases, Tenth Revision (ICD-10) could be a useful measure of treated NTM disease. Moreover, in Denmark, no studies have investigated regional differences although NTM epidemiology is known to be influenced by geography and climate [5–8].
Mycobacterium goodii central venous catheter-related bloodstream infection
Published in Baylor University Medical Center Proceedings, 2023
Anusha Ammu, Busara Songtanin, Sarath Nath
Blood culture from the day of admission grew Gram-variable rods, and the patient was started on piperacillin-tazobactam. The initial blood culture grew a rapidly growing Mycobacterium species. The catheter was removed and sent for Gram stain and culture. Repeat blood culture 2 days later also grew rapidly growing Mycobacterium species. The patient was started on an empiric regimen covering the three most common rapidly growing nontuberculous mycobacteria (NTM)—M. abscessus, M. fortuitum, and M. chelonae—with imipenem, clarithromycin, and amikacin while waiting for identification of the type of rapidly growing NTM. Repeat blood cultures on hospital day 1, day 3, and day 5 grew rapidly growing NTM. The catheter tip culture also grew a rapidly growing Mycobacterium species, which confirmed a true infection and ruled out contamination. Clarithromycin was switched to azithromycin due to the adverse effect of nausea. Repeat blood cultures on days 9 and 11 had no growth. The patient received amikacin and imipenem for a total of 4 weeks following line removal and was discharged home.
A multidisciplinary approach to the management of nontuberculous mycobacterial lung disease: a clinical perspective
Published in Expert Review of Respiratory Medicine, 2021
Nontuberculous mycobacteria (NTM) are ubiquitous environmental organisms that can colonize in the airways to cause a complex, chronic pulmonary disease that is not only difficult to manage but also often refractory to treatment [1–4]. Mycobacterium avium complex (MAC) is the NTM pathogen most commonly associated with lung disease. Symptoms of NTM lung disease (NTM-LD) include chronic cough, sputum production, hemoptysis, fatigue, malaise, and weight loss. These symptoms are nonspecific and are shared with those of other pulmonary diseases such as tuberculosis, bronchiectasis, emphysema, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF) [4–7]. Diagnosis of NTM-LD is complex, requiring careful evaluation of clinical, microbiological, and radiographic features along with the exclusion of other disorders [6–9].