Chest
Clinical InvestigationsClinical and Radiographic Manifestations of Uncommon Pulmonary Nontuberculous Mycobacterial Disease in AIDS Patients
Section snippets
Study Design
This study was conducted at the Erie County Medical Center, a 479-bed tertiary care teaching institution, affiliated with the State University of New York at Buffalo. The hospital has the largest tuberculosis clinic in Erie County and the major AIDS treatment center in the region. All mycobacterial isolates from this area are referred to the mycobacteriology laboratory at the Erie County Medical Center for final identification.
All patients with positive cultures for NTM other than MAC and M
Patient Population
One hundred sixty-eight patients were identified from the mycobacteriologic records. Fifty-four patients met the inclusion criteria for uncommon NTM disease. Fifty-one of the 54 patients included in the study were seen in the emergency department or ambulatory care clinic and were admitted to the hospital for respiratory complaints or abnormal chest radiographs suspicious for active pulmonary tuberculosis. During their hospital stay, all of the 51 patients on whom acid-fast bacilli sputum
Discussion
To our knowledge, this study is the first comprehensive description of the clinical and radiographic features of pulmonary NTM disease other than MAC or M kansasii in AIDS patients. Previous reports of NTM disease in the AIDS population were limited to anecdotal cases of disseminated NTM disease. The recognition of the pathogenecity of these microorganisms was limited by the difficulty in associating clinical disease to positive cultures, frequent coexistent pathogens, and lack of established
Addendum
Since the submission of this manuscript, the American Thoracic Society has issued revised criteria for the diagnosis of NTM.26 These criteria were developed to fit best for MAC, Mycobacterium abscessus, and M kansasii. As the authors themselves state, the applicability of the definition for other NTM is uncertain. The operational definitions of NTM lung used in our article encompass only the uncommon NTM disease as an investigational tool and differs in purpose and intent from the August 1997
References (26)
- et al.
Mycobacterium gordorme: a possible opportunistic respiratory tract pathogen in patients with advanced human immunodeficiency virus, type 1 infection
Chest
(1991) - et al.
Mycobacterium malmoense infection in HIV positive patients
J Infect
(1991) The clinical presentation, diagnosis, and therapy of cutaneous and pulmonary infections due to the rapidly growing mycobacteria, M fortuitum and M chelonae
Clin Chest Med
(1989)- et al.
Pulmonary disease from nontuberculous mycobacteria in patients with human immunodeficiency virus
Chest
(1994) - et al.
Mycobacterium kansasii: colonization and disease
Br J Dis Chest
(1986) - et al.
The epidemiology of nontuberculous mycobacterial diseases in the United States
Am Rev Respir Dis
(1987) - et al.
Clinical and roentgenographic features of nosocomial pulmonary disease due to Mycobacterium xenopi
Am Rev Respir Dis
(1981) - et al.
Clinical significance of nontuberculous mycobacteria isolates in a Canadian tertiary care center
Clin Infect Dis
(1995) - et al.
Pulmonary complications of the acquired immunodeficiency syndrome: an update: report of the Second National Heart, Lung, and Blood Institute Workshop
Am Rev Respir Dis
(1987) - et al.
Pulmonary infection with Mycobacterium avium-intracellulare: diagnosis, clinical patterns, treatment (clinical conference)
Mt Sinai J Med
(1990)
Mycobacterium kansasii: a cause of treatable pulmonary disease associated with advanced human immunodeficiency virus infection
Ann Intern Med
Extrapulmonary and disseminated infections due to Mycobacterium malmoense: case report and review
Clin Infect Dis
Right middle lobe syndrome caused by Mycobacterium fortuitum in a patient with human immunodeficiency virus infection
South Med J
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