Clinical spectrum of extrapulmonary non-tuberculous mycobacterial disease in immunocompetent patients: a case series.

IF 1.7 Q3 INFECTIOUS DISEASES
GERMS Pub Date : 2024-06-30 eCollection Date: 2024-06-01 DOI:10.18683/germs.2024.1431
Prakrati Yadav, Durga Shankar Meena, Deepak Kumar, Nikhil John, Navneet Kaur, Sarika Kombade, Gopal Krishana Bohra, Sarvesh Tiwari, Vijaylaxmi Nag
{"title":"Clinical spectrum of extrapulmonary non-tuberculous mycobacterial disease in immunocompetent patients: a case series.","authors":"Prakrati Yadav, Durga Shankar Meena, Deepak Kumar, Nikhil John, Navneet Kaur, Sarika Kombade, Gopal Krishana Bohra, Sarvesh Tiwari, Vijaylaxmi Nag","doi":"10.18683/germs.2024.1431","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Non-tuberculous mycobacterial (NTM) disease is an underdiagnosed condition that usually manifests as pulmonary infection. Extrapulmonary manifestations are rare and can be easily overlooked or misdiagnosed as tuberculosis or malignancy.</p><p><strong>Case report: </strong>Herein, we present four cases of extrapulmonary NTM disease in immunocompetent patients. Patient 1 had bone marrow suppression secondary to NTM infection. Patient 2 was diagnosed with <i>Mycobacterium abscessus</i> meningitis, brain abscess and arachnoiditis. Patient 3 had pleural effusion, and fluid cytology revealed <i>Mycobacterium fortuitum</i>. Patient 4 was a 30-year-old male with cervical lymphadenopathy due to NTM. Two patients (case 2 and case 4) were initially diagnosed with tuberculosis but showed no response to anti-tubercular drugs. One patient (case 3) died within seven days of initiation of treatment. The rest of the patients (cases 1 and 2) showed clinical improvement with antimicrobial therapy for NTM species. Case 4 responded well to surgical excision without the need for antibiotics.</p><p><strong>Conclusions: </strong>Clinicians should be vigilant about the possibility of NTM disease. Early diagnosis is vital to prevent poor outcomes, particularly in the setting of disseminated infections.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":null,"pages":null},"PeriodicalIF":1.7000,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11527488/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"GERMS","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.18683/germs.2024.1431","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: Non-tuberculous mycobacterial (NTM) disease is an underdiagnosed condition that usually manifests as pulmonary infection. Extrapulmonary manifestations are rare and can be easily overlooked or misdiagnosed as tuberculosis or malignancy.

Case report: Herein, we present four cases of extrapulmonary NTM disease in immunocompetent patients. Patient 1 had bone marrow suppression secondary to NTM infection. Patient 2 was diagnosed with Mycobacterium abscessus meningitis, brain abscess and arachnoiditis. Patient 3 had pleural effusion, and fluid cytology revealed Mycobacterium fortuitum. Patient 4 was a 30-year-old male with cervical lymphadenopathy due to NTM. Two patients (case 2 and case 4) were initially diagnosed with tuberculosis but showed no response to anti-tubercular drugs. One patient (case 3) died within seven days of initiation of treatment. The rest of the patients (cases 1 and 2) showed clinical improvement with antimicrobial therapy for NTM species. Case 4 responded well to surgical excision without the need for antibiotics.

Conclusions: Clinicians should be vigilant about the possibility of NTM disease. Early diagnosis is vital to prevent poor outcomes, particularly in the setting of disseminated infections.

免疫功能正常患者肺外非结核分枝杆菌病的临床表现:一个病例系列。
导言:非结核分枝杆菌(NTM)疾病是一种诊断不足的疾病,通常表现为肺部感染。肺外表现很少见,很容易被忽视或误诊为肺结核或恶性肿瘤:在此,我们介绍了四例免疫功能正常患者的肺外 NTM 疾病。患者 1 因继发 NTM 感染而出现骨髓抑制。患者 2 被诊断为脓肿分枝杆菌脑膜炎、脑脓肿和蛛网膜炎。患者 3 患有胸腔积液,积液细胞学检查显示为福特分枝杆菌。患者 4 是一名 30 岁的男性,因 NTM 引起颈淋巴结病。两名患者(病例 2 和病例 4)最初被诊断为肺结核,但对抗结核药物无反应。一名患者(病例 3)在开始治疗后七天内死亡。其余患者(病例 1 和 2)在接受抗 NTM 菌治疗后,临床症状有所改善。病例 4 对手术切除反应良好,无需使用抗生素:临床医生应警惕 NTM 疾病的可能性。结论:临床医生应警惕 NTM 疾病的可能性,早期诊断对防止不良后果至关重要,尤其是在播散性感染的情况下。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
GERMS
GERMS INFECTIOUS DISEASES-
CiteScore
2.80
自引率
5.00%
发文量
36
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信