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Mycobacterium Intracellulare Infection

Infection Due to Mycobacterium Intracellulare [battey Bacillus]


Presentation

  • This is a rare form of presentation for this infection in AIDS patients. We speculate that the antiviral drug AZT was responsible for the localization of disease.[ncbi.nlm.nih.gov]
  • Abstract A case of a 29-year-old woman with intralobar pulmonary sequestration infected with Mycobacterium intracellulare is presented.[ncbi.nlm.nih.gov]
  • We present a case of a woman with medically refractory ulcerative colitis (UC) who developed severe bronchiectasis, bronchitis, bronchiolitis and Mycobacterium intracellulare (MAC) infection 2 years after total colectomy.[ncbi.nlm.nih.gov]
  • A 35-year-old Tanzanian man presented with history of cough, fever, chest pain and night sweats for 4 weeks. The patient had a history of tuberculosis 4 years ago. On physical examination, there were no significant findings.[ncbi.nlm.nih.gov]
  • Packer SJ, Cesario T, Williams JH Jr: Mycobacterium avium complex infection presenting as endobronchial lesions in immunosuppressed patients. Ann Intern Med 1988;109:389–393.[karger.com]
Fever
  • A 35-year-old Tanzanian man presented with history of cough, fever, chest pain and night sweats for 4 weeks. The patient had a history of tuberculosis 4 years ago. On physical examination, there were no significant findings.[ncbi.nlm.nih.gov]
  • Descriptive Epidemiology 587 Mechanisms and Routes of Transmission 7 Pathogenesis and Immunity 590 Patterns of Host Response 591 Control and Prevention 592 References 593 Suggested Reading 595 Rocky Mountain Spotted Fever Theodore E Woodward and J Stephen[books.google.com]
  • Clinical manifestations of disseminated MAC—such as fever, weight loss, and night sweats—should be monitored several times during the initial weeks of therapy.[en.wikipedia.org]
  • The patient was a 45-year-old Japanese female with fever, loss of body weight and cervical lymphadenopathy.[karger.com]
  • 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[medlineplus.gov]
Weight Loss
  • Clinical manifestations of disseminated MAC—such as fever, weight loss, and night sweats—should be monitored several times during the initial weeks of therapy.[en.wikipedia.org]
  • 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[medlineplus.gov]
  • Patients are feverish, with drenching night sweats and weight loss. In the rare case of MAC in a patient without HIV, the organisms primarily infect the lung, causing a productive cough and sometimes fever and weight loss.[humpath.com]
  • The symptoms of MAC can include high fevers, chills, diarrhea, weight loss, stomach aches, fatigue, and anemia (low numbers of red blood cells).[aidsinfonet.org]
  • Weight loss. Nonspecific focal chest signs: crackles, wheeze, bronchial breathing, dullness to percussion. Clubbing (in cases with underlying bronchiectasis).[patient.info]
Fishing
  • Fish, M.D. Abstract Pulmonary disease caused by Mycobacterium avium complex usually occurs in patients with chronic lung disease or deficient cellular immunity, and its prevalence is increasing.[nejm.org]
  • Those who are most at risk include people with weakened immune systems and people who handle fish, are exposed to contaminated water in aquariums, or swim in fresh or salt water that contains the mycobacterium.[humanillnesses.com]
  • Other risk factors for acquisition of MAC infection include using an indoor swimming pool, consumption of raw or partially cooked fish or shellfish, bronchoscopy and treatment with granulocyte stimulating factor.[en.wikipedia.org]
  • […] tenosynovitis, arthritis, osteomyelitis ) Mycobacterium ulcerans Also known as Buruli ulcer, Kumusi, Bairnsdale ulcer Infection most common in Central and West Africa around areas of lush vegetation and swamps but may also occur in Australia Found in fish[dermnetnz.org]
Streptococcal Infection
  • Infections Barry M Gray 1 Introduction 673 Methodology 676 Biological Characteristics of the Organisms 684 Descriptive Epidemiology 688 Mechanisms and Routes of Transmission 694 Pathogenesis and Immunity 695 Patterns of Host Response 697 Control and[books.google.com]
Rhinitis
  • Therefore information on prevalence of eczema, food allergies and allergic rhinitis (the other diseases of the atopic march) was not available for most of these patients.[respiratory-research.biomedcentral.com]
Diarrhea
  • MAC bacteria should always be considered in a person with HIV infection presenting with diarrhea.[en.wikipedia.org]
  • Azithromycin (Zithromax, see fact sheet 530): nausea, headaches, vomiting, diarrhea; taken as capsules or intravenously. Ciprofloxacin (Cipro or Ciloxan, see fact sheet 531): nausea, vomiting, diarrhea; taken as tablets or intravenously.[aidsinfonet.org]
  • 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]
  • Both drugs can cause nausea, headaches, vomiting, and diarrhea and increased liver enzymes. Experts recommend testing blood samples to determine whether the bacteria are susceptible to either antibiotic.[poz.com]
  • Symptoms include fever, weight loss, sweats/chills, diarrhea, cramping, unexpected tiredness, and anemia (low red blood cells). Antibiotics are used to prevent and treat MAC. What is MAC? MAC is caused by bacteria called Mycobacterium avium complex.[catie.ca]
Abdominal Pain
  • Side effects from clarithromycin and azithromycin may include the following: nausea vomiting abdominal pain an altered sense of taste temporary liver injury If your side effects are bothersome, ask your doctor for advice to manage them.[catie.ca]
  • MAC medications can have side effects, such as: Feeling queasy, throwing up, or diarrhea Abdominal pain Eye swelling that brings eye pain , light sensitivity , redness, or blurred vision Rashes , itching Anemia Hearing Loss Numbness in feet Hearing loss[webmd.com]
  • Pulmonary involvement is similar to TB, while diarrhea and abdominal pain are associated with gastrointestinal involvement.[en.wikipedia.org]
  • Fever is the main symptom of MAC, along with night sweats, loss of appetite, chills, weight loss, muscle wasting, abdominal pain, tiredness, and diarrhea. MAC can also enlarge the liver, spleen, and lymph nodes.[poz.com]
Arthritis
  • Case Report A 65-year-old Mexican man with rheumatoid arthritis was admitted to the hospital with left-sided chest pain, productive cough and progressive dyspnea over a week.[ijcasereportsandimages.com]
  • Autoimmune disease was recorded in 36 patients (13.1%), with 19 (52.8%) having rheumatoid arthritis ( table 1 ).[bmjopenrespres.bmj.com]
  • […] drainage (sporotrichoid forms) Most often affects elbows, knees, top of feet, knuckles or fingers Multiple lesions and widespread disease may occur in immunocompromised patients Rarely causes red, swollen and tender joints (bursitis, tenosynovitis, arthritis[dermnetnz.org]
  • Septic arthritis. Osteomyelitis. Skin and soft tissue infections (commonly presenting as flesh-coloured/purple-red nodules, ulcers, folliculitis, abscesses or pustules). [ 8 ] Tenosynovitis.[patient.info]
Fracture
  • The infection later progressed, involving generalized lymphadenopathy, liver splenic and cutaneous abscesses, pulmonary infiltration, pleural effusion, and costal fracture.[karger.com]

Workup

Pulmonary Infiltrate
  • infiltrations in immunocompromised hosts, primarily patients with AIDS (96 patients).[ncbi.nlm.nih.gov]
  • The infection later progressed, involving generalized lymphadenopathy, liver splenic and cutaneous abscesses, pulmonary infiltration, pleural effusion, and costal fracture.[karger.com]
  • Seite 643 - Short-course empiric antibiotic therapy for patients with pulmonary infiltrates in the intensive care unit. A proposed solution for indiscriminate antibiotic prescription. Am J Respir Crit Care Med. ‎[books.google.de]
Lymphocytopenia
  • A population of Vdelta1( )Vgamma9(-) gammadelta T cells that represented almost the totality (84%) of circulating lymphocytes in a patient with chronic, non-HIV-related, CD4 lymphocytopenia complicated by a disseminated Mycobacterium intracellulare infection[ncbi.nlm.nih.gov]
Polyps
  • Gotoh T, Fujii T, Hiramori N, Fujita Y, Kida T, Iwasaki Y, Fukabori T, Tanaka Y, Hara H, Nakamura T, Nakagawa M: A case of disseminated atypical mycobacteriosis with multiple bronchial polyps. Nippon Kyobu Shikkan Gakkai Zasshi 1990;28:1628–1634.[karger.com]
  • Sex 22 female, 14 male 17 female, 21 male p  0.16 Subjects culturing multiple NTM species 18 (50%) 8 (21%) p  0.009 Asthma 6 (17%) 4 (11%) p  0.44 COPD 9 (25%) 15 (39%) p  0.18 Bronchiectasis 15 (42%) 5 (13%) p  0.006 ABPA 1 (3%) 0 (0%) p  0.30 Nasal Polyps[respiratory-research.biomedcentral.com]
Granulomatous Tissue
  • The infections were characterized histopathologically by poor or absent granulomatous tissue reaction. Clinical isolates of M. avium-intracellulare from all five patients agglutinated with type 8 antisera.[annals.org]

Treatment

  • Addition of immunosuppressive therapy to her antimycobacterial treatment resulted in sustained and complete clinical remission of her disease.[ncbi.nlm.nih.gov]
  • After 3 months of treatment with clarithromycin, streptomycin, rifampicin and ethambutol, the patient underwent partial resection of the left lower lobe. At the 6-month follow-up the patient's clinical status is excellent.[ncbi.nlm.nih.gov]
  • With no specific national guidelines at our setting the patient received standard antituberculosis treatment and is kept under close follow-up.[ncbi.nlm.nih.gov]
  • Treatment typically lasts at least 12 months.[en.wikipedia.org]
  • Controlled trial of 6-month and 8-month regimens in the treatment of pulmonary tuberculosis: the results up to 24 months. ‏[books.google.com]

Prognosis

  • Prognosis depends on the form of the disease. In the upper lobe cavitary form, lung destruction is usually progressive and can lead to respiratory failure and death if successful treatment is not instituted.[radiopaedia.org]
  • Focal nodular disease has the best prognosis and tends to be fairly benign.[patient.info]
  • Finally, since we did not analyse an association of co-infection with the outcome or prognosis, we could not show the clinical significance of co-infection in this study.[bmjopenrespres.bmj.com]

Etiology

  • Biopsy of the right thumb demonstrated irregular pseudoepitheliomatous hyperplasia associated with a suppurative dermal infiltrate, which was highly suspicious for an infectious etiology (H&E, original magnification 40).[mdedge.com]
  • […] clinical specimen, on a submitted AFB conventional solid medium, or an AFB broth medium Volume Pure culture isolate on an AFB conventional solid medium or a minimum of 1 mL of AFB broth medium Container Conventional or broth medium, tightly sealed, in etiologic[labcorp.com]
  • Some have hypothesized and debated for decades that M. avium subspecies paratuberculosis is the etiological agent of Crohn disease in humans without strong evidence.[ncbi.nlm.nih.gov]
  • Other bacterial etiologies causing a more chronic, less clinically catastrophic complications include Nocardia and Actinomyces species. Parasites such as Echinococcus and Paragonimus species have been described to cause a similar setting.[ijcasereportsandimages.com]

Epidemiology

  • Descriptive Epidemiology 587 Mechanisms and Routes of Transmission 7 Pathogenesis and Immunity 590 Patterns of Host Response 591 Control and Prevention 592 References 593 Suggested Reading 595 Rocky Mountain Spotted Fever Theodore E Woodward and J Stephen[books.google.com]
  • BACKGROUND: Although the incidence rates of non-tuberculous mycobacteria (NTM) have been increasing in many countries, the basic epidemiology of NTM remains to be fully understood.[ingentaconnect.com]
  • "Disseminated Mycobacterium avium complex infection: clinical identification and epidemiologic trends". J. Infect. Dis. 165 (3): 577–80. doi : 10.1093/infdis/165.3.577. PMID 1347060. a b c d e f g h i U.S.[en.wikipedia.org]
  • Mycobacterium avium complex pulmonary disease: new epidemiology and management concepts. Curr. Opin. Infect. Dis. 2018 Apr; 31 (2):199-207. [ PubMed : 29346118 ] 17.[ncbi.nlm.nih.gov]
  • ., AIDS) most commonly caused by MAC skin and soft tissue infection most commonly caused by M. marinum typically due to direct inoculation of the organism Epidemiology incidence the most common nontuberculous species that cause disease in humans in the[medbullets.com]
Sex distribution
Age distribution

Pathophysiology

  • Effective prevention and therapy of MAC has the potential to contribute substantially to improved quality of life and duration of survival for HIV-infected persons. [12] Pathophysiology [ edit ] Mycobacterium avium complex is the most commonly found form[en.wikipedia.org]
  • Childhood lymphadenitis due to MAC is very rare but appears to be on the increase in developed countries. [ 3 ] Pathophysiology M. avium causes 95% of AIDS-related MAC infections. [ 4 ] M. intracellulare causes 40% of MAC infections in the immunocompetent[patient.info]
  • Whilst disseminated NTM infections are associated with severe immunodeficiency states such as HIV infection or defects in interferon gamma (IFNγ) and STAT3 pathways [ 7 ], the pathophysiology of localised pulmonary NTM infection is unclear [ 8 ].[respiratory-research.biomedcentral.com]
  • The ecological niche of this organism has not been identified. [7] [8] Pathophysiology MAC is acquired by inhalation and can also be ingested into the gastrointestinal tract, where it adheres to the mucosal epithelial cells and infects the macrophages[ncbi.nlm.nih.gov]

Prevention

  • Descriptive Epidemiology 587 Mechanisms and Routes of Transmission 7 Pathogenesis and Immunity 590 Patterns of Host Response 591 Control and Prevention 592 References 593 Suggested Reading 595 Rocky Mountain Spotted Fever Theodore E Woodward and J Stephen[books.google.com]
  • However, MAC disease is preventable. One of the best ways to prevent it is to avoid CD4 counts from dropping below 100 by starting potent HIV treatment. In people whose CD4 counts do not respond adequately, preventive drugs are taken.[poz.com]
  • Centers for Disease Control and Prevention (July 1, 2010 Reviewed). Diagnosis of Tuberculous Disease. Available online at through . Accessed January 2011. Centers for Disease Control and Prevention.[labtestsonline.it]
  • Centers for Disease Control and Prevention (July 1, 2010 Reviewed). Diagnosis of Tuberculous Disease. Available online at . Accessed January 2011. Centers for Disease Control and Prevention.[labtestsonline.it]
  • Prevention It is not possible to avoid being exposed to the bacteria that cause MAC. The best way to prevent developing the disease is to keep your immune system strong and your CD4 count well above 50.[catie.ca]

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