Edit concept Question Editor Create issue ticket

Disseminated Atypical Mycobacterial Infection


Presentation

  • This case highlights the need to maintain an elevated index of suspicion for atypical pathogens with unusual clinical presentations among the lung transplant population.[ncbi.nlm.nih.gov]
  • They presented with fever, weight loss, lymphadenopathy, and hepatosplenomegaly. They had anaemia and an acute phase response.[ncbi.nlm.nih.gov]
  • Clinically, these patients had symptoms of fever and chills; an infiltrate was usually present on chest radiography.[ncbi.nlm.nih.gov]
  • Appendix C presents, also in summary form, drugs, regimens, duration of treatment, and toxicities to permit ready reference to less familiar anti microbial agents.[books.google.com]
  • Here we present a case of a sevenmonth- old boy presented with multiple neck and axillary swellings. The patient was treated medically and then came back with a relapse. Eventually, he was diagnosed with IL-12 deficiency.[alliedacademies.org]
Fever
  • Such infection should be suspected in a patient with hairy cell leukemia who has persistent fever without an obvious source. Tissue biopsy usually led to diagnosis; urine cultures were also positive in two patients.[ncbi.nlm.nih.gov]
  • They presented with fever, weight loss, lymphadenopathy, and hepatosplenomegaly. They had anaemia and an acute phase response.[ncbi.nlm.nih.gov]
  • Clinically, these patients had symptoms of fever and chills; an infiltrate was usually present on chest radiography.[ncbi.nlm.nih.gov]
  • Patient 4, a man aged 36 years, presented with fever, chronic fever, and diarrhea of 5 months' duration. Physical examination revealed oral candidiasis. No lymphadenopathy was detected.[cdc.gov]
  • At other times, they can cause lung symptoms similar to tuberculosis: Cough Weight loss Coughing up blood or mucus Weakness or fatigue Fever and chills Night sweats Lack of appetite and weight loss Medicines can treat these infections, but often more[icdlist.com]
Fever
  • Such infection should be suspected in a patient with hairy cell leukemia who has persistent fever without an obvious source. Tissue biopsy usually led to diagnosis; urine cultures were also positive in two patients.[ncbi.nlm.nih.gov]
  • They presented with fever, weight loss, lymphadenopathy, and hepatosplenomegaly. They had anaemia and an acute phase response.[ncbi.nlm.nih.gov]
  • Clinically, these patients had symptoms of fever and chills; an infiltrate was usually present on chest radiography.[ncbi.nlm.nih.gov]
  • Patient 4, a man aged 36 years, presented with fever, chronic fever, and diarrhea of 5 months' duration. Physical examination revealed oral candidiasis. No lymphadenopathy was detected.[cdc.gov]
  • At other times, they can cause lung symptoms similar to tuberculosis: Cough Weight loss Coughing up blood or mucus Weakness or fatigue Fever and chills Night sweats Lack of appetite and weight loss Medicines can treat these infections, but often more[icdlist.com]
Weight Loss
  • They presented with fever, weight loss, lymphadenopathy, and hepatosplenomegaly. They had anaemia and an acute phase response.[ncbi.nlm.nih.gov]
  • At other times, they can cause lung symptoms similar to tuberculosis: Cough Weight loss Coughing up blood or mucus Weakness or fatigue Fever and chills Night sweats Lack of appetite and weight loss Medicines can treat these infections, but often more[icdlist.com]
  • Signs and symptoms There are four main symptom types: Pulmonary (lung) disease Symptoms may include: cough fatigue shortness of breath blood-stained sputum (phlegm) weight loss chest pain.[sahealth.sa.gov.au]
  • If MAC goes all over your body, you may have: High fever or chills Night sweats Belly pain Diarrhea Weight loss Fatigue Swollen glands Fewer red blood cells ( anemia ) You could also have more serious symptoms like: Blood infections Hepatitis Pneumonia[webmd.com]
  • Two weeks prior to presentation, he had intermittent fever associated with sweating and loss of appetite but no rigors or weight loss.[alliedacademies.org]
Weight Loss
  • They presented with fever, weight loss, lymphadenopathy, and hepatosplenomegaly. They had anaemia and an acute phase response.[ncbi.nlm.nih.gov]
  • At other times, they can cause lung symptoms similar to tuberculosis: Cough Weight loss Coughing up blood or mucus Weakness or fatigue Fever and chills Night sweats Lack of appetite and weight loss Medicines can treat these infections, but often more[icdlist.com]
  • Signs and symptoms There are four main symptom types: Pulmonary (lung) disease Symptoms may include: cough fatigue shortness of breath blood-stained sputum (phlegm) weight loss chest pain.[sahealth.sa.gov.au]
  • If MAC goes all over your body, you may have: High fever or chills Night sweats Belly pain Diarrhea Weight loss Fatigue Swollen glands Fewer red blood cells ( anemia ) You could also have more serious symptoms like: Blood infections Hepatitis Pneumonia[webmd.com]
  • Two weeks prior to presentation, he had intermittent fever associated with sweating and loss of appetite but no rigors or weight loss.[alliedacademies.org]
Lymphadenopathy
  • They presented with fever, weight loss, lymphadenopathy, and hepatosplenomegaly. They had anaemia and an acute phase response.[ncbi.nlm.nih.gov]
  • No lymphadenopathy was noted. Patient 4, a man aged 36 years, presented with fever, chronic fever, and diarrhea of 5 months' duration. Physical examination revealed oral candidiasis. No lymphadenopathy was detected.[cdc.gov]
  • Skin lesions and childhood lymphadenopathy are usually cured by surgery, sometimes in combination with anti-mycobacterial drugs. Disseminated and pulmonary infections are treated with combinations of anti-mycobacterial drugs.[ideas.health.vic.gov.au]
  • . , Altman , P. ( 1984 ) Chronic lymphadenopathy due to mycobacterial infection. Clinical features, diagnosis, histopathology and management . American Journal of Diseases of Children 138 : 917 – 922 . Olson , N.[cambridge.org]
  • Surgical excision is also frequently used to hasten resolution of localized lymphadenopathy and of solitary skin lesions, even though these lesions are likely to be self-limiting.[apps.who.int]
Hypertension
  • We describe a case of disseminated Mycobacterium avium-complex (MAC) in a lung transplant recipient presenting as granulomatous liver disease with signs of portal hypertension.[ncbi.nlm.nih.gov]
Hepatosplenomegaly
  • They presented with fever, weight loss, lymphadenopathy, and hepatosplenomegaly. They had anaemia and an acute phase response.[ncbi.nlm.nih.gov]
  • At the age of five, he had night sweats, fever, sinusitis, cervical adenitis, diarrhea, hepatosplenomegaly, and failure to thrive. Cultures of sinus, lymph node, blood, marrow, and gastric aspirate grew M. avium complex.[nejm.org]
Suggestibility
  • Current literature suggests a favorable prognosis in most cases of MAC infection in lung transplant recipients with appropriate treatment.[ncbi.nlm.nih.gov]
  • Clinical and immunological features suggest that these patients are phenotypically similar to Lsh/Ity/Bcg susceptible mice. Understanding of this defect may provide insights into the mechanisms responsible for susceptibility to mycobacteria.[ncbi.nlm.nih.gov]
  • These are suggestive only, useful when the general nature of the organism is known but not the specific susceptibility of the individual strain.[books.google.com]
  • Spread of M. abscessus between cystic fibrosis patients was strongly suggested by a United Kingdom study in 2013 (see ‘Additional sources of information’).[ideas.health.vic.gov.au]
  • This suggested that specific T cell products or activities were required for mycobacterial resistance. 2) An association was noted between pulmonary nontuberculous mycobacterial infections and a particular body habitus, predominantly in post-menopausal[clinicaltrials.gov]

Workup

  • The patient was transferred for further workup and treatment of combined MTB and MAC infection. Two months later, the patient was diagnosed with IL-12 deficiency.[alliedacademies.org]
Mycobacterium Avium Complex
  • We describe a case of disseminated Mycobacterium avium-complex (MAC) in a lung transplant recipient presenting as granulomatous liver disease with signs of portal hypertension.[ncbi.nlm.nih.gov]
  • avium complex - Ziehl Neelsen (acid fast) stain (right: lymph node) Positive stains Acid fast stains large numbers of intracellular bacteria; bacilli are longer (20 microns), more coarsely beaded and more bent than M. tuberculosis bacilli PAS positive[pathologyoutlines.com]
  • The pathophysiology of disseminated Mycobacterium avium complex disease in AIDS. J Infect Dis. 1999; 179: S461-465. Vankayalapati R, Wizel B, Samten B, et al. Cytokine profiles in immunocompetent persons infected with Mycobacterium avium complex.[alliedacademies.org]
  • Mycobacterium avium complex (MAC) and Mycobacterium scrofulaceum are associated in immuno-competent children with lymphadenitis.[ispub.com]
  • avium complex Mycobacterium avium intracellulare, localized Non-tuberculous mycobacterial pneumonia Pulmonary mycobacterial avium Pulmonary mycobacterium avium complex infection ICD-10-CM A31.0 is grouped within Diagnostic Related Group(s) (MS-DRG v[icd10data.com]
Mycobacterium Kansasii
  • Six patients had infections with Mycobacterium kansasii; two with M. avium-intracellulare; and one with M. chelonei.[ncbi.nlm.nih.gov]
  • Mycobacterium kansasii should be treated with at least 3 drugs for 12–18 months. One of the drugs must be rifampicin , which is still the cornerstone of treatment for these infections.[dermnetnz.org]
  • Applicable To Infection due to Mycobacterium avium Infection due to Mycobacterium intracellulare [Battey bacillus] Infection due to Mycobacterium kansasii The following code(s) above A31.0 contain annotation back-references Annotation Back-References[icd10data.com]
  • The most common species of mycobacterium that cause such infections include: Mycobacterium avium-intracellulare Mycobacterium kansasii Mycobacterium marinum Mycobacterium ulcerans Mycobacterium chelonae Mycobacterium fortuitum Mycobacterium abscessus[dovemed.com]
  • Mycobacterium kansasii Infection with Mycobacterium kansasii (kan-ZAS-e-eye) causes a lung disease similar to tuberculosis, although not as severe.[encyclopedia.com]
Mycobacterium Kansasii
  • Six patients had infections with Mycobacterium kansasii; two with M. avium-intracellulare; and one with M. chelonei.[ncbi.nlm.nih.gov]
  • Mycobacterium kansasii should be treated with at least 3 drugs for 12–18 months. One of the drugs must be rifampicin , which is still the cornerstone of treatment for these infections.[dermnetnz.org]
  • Applicable To Infection due to Mycobacterium avium Infection due to Mycobacterium intracellulare [Battey bacillus] Infection due to Mycobacterium kansasii The following code(s) above A31.0 contain annotation back-references Annotation Back-References[icd10data.com]
  • The most common species of mycobacterium that cause such infections include: Mycobacterium avium-intracellulare Mycobacterium kansasii Mycobacterium marinum Mycobacterium ulcerans Mycobacterium chelonae Mycobacterium fortuitum Mycobacterium abscessus[dovemed.com]
  • Mycobacterium kansasii Infection with Mycobacterium kansasii (kan-ZAS-e-eye) causes a lung disease similar to tuberculosis, although not as severe.[encyclopedia.com]
Mycobacterium Fortuitum
  • A range of different mycobacteria (Mycobacterium fortuitum, M chelonei, and four strains of M avium intracellulare complex) were isolated.[ncbi.nlm.nih.gov]
  • Clinical and pathologic features with Mycobacterium fortuitum infections. An emerging pathogen in patients with AIDS. Am J Clin Pathol 2001;16:225–232. 6. Mederos LM, Gonzalez D, Banderas F, et al.[basicmedicalkey.com]
  • […] avium-intracellulare and Mycobacterium kansasii primarily cause lung disease similar to pulmonary TB, whilst Mycobacterium marinum, Mycobacterium ulcerans, Mycobacterium fortuitum and Mycobacterium chelonae cause skin infections.[dermnetnz.org]
  • The most common species of mycobacterium that cause such infections include: Mycobacterium avium-intracellulare Mycobacterium kansasii Mycobacterium marinum Mycobacterium ulcerans Mycobacterium chelonae Mycobacterium fortuitum Mycobacterium abscessus[dovemed.com]
  • Mycobacterium fortuitum -induced persistent parotitis: successful therapy with clarithromycin and ciprofloxacin. Head Neck 29, 1061 –1064. [CrossRef] [Google Scholar] Cox, H. J., Brightwell, A. P. & Riordan, T. ( 1995 ; ).[jmm.microbiologyresearch.org]
Staphylococcus Aureus
  • Pneumonia Caused by Methicillin-Resistant Staphylococcus aureus. Infectious Disease Society of America. Oxford University Press. Available online at . Accessed April 25, 2014. Klebsiella pneumonia in Healthcare Settings.[labtestsonline.it]

Treatment

  • Treatment with multiple antibiotics failed to eradicate the infection, although treatment with gamma interferon was associated with improvement. Three have died and the surviving children have chronic infection.[ncbi.nlm.nih.gov]
  • Current literature suggests a favorable prognosis in most cases of MAC infection in lung transplant recipients with appropriate treatment.[ncbi.nlm.nih.gov]
  • The aim of the book is to provide a broad readership with a comprehensive, highly illustrated overview of the diseases covered and a practical guide to their diagnosis and treatment.[books.google.com]
  • Treatment with multiple anti-tuberculosis drugs was initiated either empirically (six patients); after obtaining pathologic evidence of granuloma or acid-fast bacilli (two patients); or after obtaining a positive culture result (one patient).[ncbi.nlm.nih.gov]
  • Appendix C presents, also in summary form, drugs, regimens, duration of treatment, and toxicities to permit ready reference to less familiar anti microbial agents.[books.google.com]

Prognosis

  • Current literature suggests a favorable prognosis in most cases of MAC infection in lung transplant recipients with appropriate treatment.[ncbi.nlm.nih.gov]
  • Prognosis The prognosis is good with proper medical and surgical treatment.[patient.info]
  • Ollé Goig JE, Sandy R (2003) Prognosis of mono-and polydrug resistant pulmonary tubercolosis in the city of Santa Cruz, Bolivia. Arch Bronconeumol 39:382–386 PubMed CrossRef Google Scholar 13.[link.springer.com]

Etiology

  • The pericardial effusion was suggestive of tuberculous origin, however, lack of response to conventional anti-tuberculous therapy raised suspicion about the etiology of the effusion being non-tuberculous.[ispub.com]
  • (Etiology) Atypical Mycobacterial Infections are caused by any species of non-tuberculous mycobacteria. Up to 13 distinct species of atypical mycobacteria are known to cause human infection.[dovemed.com]

Epidemiology

  • It discusses the epidemiological and clinical aspects of each disease in detail and illustrates the biology and life cycle of the causatory organism, as well as the pathology associated with infection and details of the treatment and long term management[books.google.com]
  • The aim has not been to produce an exhaustive account of mycobacteria and mycobacterioses, but rather to concentrate on salient points and particularly on those most generally useful to a diverse group of interests: mycobacteriology, pathology, epidemiology[books.google.com]
  • The epidemiology of disseminated non-tuberculous mycobacterial infection in the acquired immunodeficiency syndrome (AIDS). Am Rev of Resp Dis 1989; 139: 4 7. Sanders JW, Walsh AD, Sinder RL, Sahn EE.[ispub.com]
  • Ocular infections caused by non-tuberculous mycobacteria: update on epidemiology and management.Girgis DO1, Karp CL, Miller D. Clin Experiment Ophthalmol. 2012;40:467-75.[kiyosawa.or.jp]
  • Acknowledgments This report is based on data contributed by S Tansuphasawadikul, B Eampokalap, A Chaovavanich, Bamrasnaradura Hospital, Nonthaburi; S Rheanpumikankit, Field Epidemiology Training Program, Ministry of Health, Thailand.[cdc.gov]
Sex distribution
Age distribution

Pathophysiology

  • The pathophysiology of disseminated Mycobacterium avium complex disease in AIDS. J Infect Dis. 1999; 179: S461-465. Vankayalapati R, Wizel B, Samten B, et al. Cytokine profiles in immunocompetent persons infected with Mycobacterium avium complex.[alliedacademies.org]

Prevention

  • (November 6, 2017) Centers for Disease Control and Prevention. CDC Features: Pneumonia can be prevented—vaccines can help. Available online at . Accessed on September 8, 2018. (November 10, 2017) Centers for Disease Control and Prevention.[labtestsonline.it]
  • You can prevent MAC by starting antiretroviral therapy (ART) early and not allow your CD4 count to get low.[webmd.com]
  • Can People Prevent Atypical Mycobacterial Infections? Because mycobacteria are common in the environment, these infections are difficult to prevent, especially in people with weakened immune systems.[encyclopedia.com]
  • Control measures for mycobacterial infections (non-tuberculosis) Preventive measures As little information is known about the mode of transmission, the prevention of atypical mycobacterial infections is difficult.[ideas.health.vic.gov.au]
  • Specific prevention options for Atypical Mycobacterial Infections depend on the infecting species type.[dovemed.com]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!