Presentation
Hot tub lung: an intriguing diffuse parenchymal lung disease Abstract In pulmonary medicine, identical pathogenesis due to varied etiological agents can present with indistinguishable clinical presentation, and produce similar laboratory and radiological [ajol.info]
Histologically, granulomatous inflammation, with or without necrosis, is present. [uscapknowledgehub.org]
This is known as Lady Windermere syndrome. [ 6 ] MAC can also present as a hypersensitivity pneumonitis. [patient.info]
Persons with HIV can present with intrathoracic adenopathy. [cancertherapyadvisor.com]
Springfield, Illinois, USA A 46 year old immunocompetent Caucasian female presented with a 2 week history of right sided chest discomfort, nonproductive cough, shortness of breath, and myalgias. [thoracic.org]
Entire Body System
- Increased Energy
Effective therapy is usually associated with decreased cough and sputum production and systemic improvement, such as increased energy and resolution of low-grade fever. [academic.oup.com]
- Recurrent Bronchitis
The presence of bronchiectasis, part of the pulmonary pathology of NTM pulmonary infection, can result in recurrent chest infections with bacterial pathogens, presenting as recurrent bronchitis or pneumonia. [academic.oup.com]
- Noncompliance
The single clinical trial using clarithromycin monotherapy noted only 1 case of acquired clarithromycin resistance (8% of patients), in a noncompliant patient who prematurely discontinued therapy. 35 There are other case reports of clarithromycin resistance [jamanetwork.com]
Respiratoric
- Cough
If your primary care provider cannot help your chronic cough, you might need to see a lung specialist. [lung.org]
What Is Causing Your Chronic Cough? A chronic cough is a cough that persists over time. [medicinenet.com]
Episodes of fever and dyspnoea are common, as well as a more gradual onset of dyspnoea and cough. [err.ersjournals.com]
[…] that helps bring up mucus (huff cough), and aerobic exercise. [rarediseases.org]
Figure 2. 83 year old lady with a chronic cough. [massgeneral.org]
- Hemoptysis
The most common respiratory symptoms of NTM lung disease are: Cough that won't go away Coughing up blood (hemoptysis) Shortness of breath when active Other symptoms of NTM lung disease include: Fatigue Low-grade fever Night sweats Weight loss What Causes [lung.org]
However, most have a combination of respiratory and systemic features similar to tuberculosis ; chronic cough shortness of breath on exertion hemoptysis low-grade fever night sweats fatigue weight loss As with M. tuberculosis NTMs commonly cause pulmonary [radiopaedia.org]
The most common symptoms include a persistent cough, fatigue, weight loss, night sweats, and occasionally shortness of breath (dyspnea) and coughing up of blood (hemoptysis). [rarediseases.org]
The classic symptoms include cough, hemoptysis, fatigue, weight loss, and night sweats, though atypical presentations are common. [cancertherapyadvisor.com]
Respiratory insufficiency and persistent hemoptysis may develop. Fibronodular infiltrates on chest x-ray resemble those of pulmonary TB, but cavitation tends to be thin-walled, and pleural effusion is rare. [merckmanuals.com]
- Chronic Cough
Figure 2. 83 year old lady with a chronic cough. [massgeneral.org]
What Is Causing Your Chronic Cough? A chronic cough is a cough that persists over time. [medicinenet.com]
If your primary care provider cannot help your chronic cough, you might need to see a lung specialist. [lung.org]
However, most have a combination of respiratory and systemic features similar to tuberculosis ; chronic cough shortness of breath on exertion hemoptysis low-grade fever night sweats fatigue weight loss As with M. tuberculosis NTMs commonly cause pulmonary [radiopaedia.org]
It can be caused by many NTM species which depends on region, but most frequently MAC and M. kansasii. [14] Clinical symptoms vary in scope and intensity but commonly include chronic cough, often with purulent sputum. Hemoptysis may also be present. [en.wikipedia.org]
- Dry Cough
She was first to get sick, with shortness of breath and a dry cough that progressed to fevers as high as 104, chills, night sweats and weight loss. [nytimes.com]
The most common symptom of NTM lung disease is a chronic or recurring dry cough, occasionally with sputum. [medicinenet.com]
Case A 56-year-old Caucasian man with past medical history of COPD secondary to tobacco abuse (40 packs per year of smoking) and chronic alcohol abuse presented to the Emergency Department with several months of increasing dyspnea, dry cough, fatigue, [pulmonarychronicles.com]
Case 1: This patient, a 46-year-old woman, was in excellent health until early June, when she noted the onset of shortness of breath and a dry cough. A chest radiograph at that time was consistent with early right lower lobe bronchial pneumonia. [wwwnc.cdc.gov]
- Productive Cough
Over the course of a week, fevers with temperatures up to 102.4°F, night sweats, progressive dyspnea, and a worsening, now productive cough developed. [uscapknowledgehub.org]
Case 2: The 44-year-old husband of Patient 1 was well until mid-August when he had onset of productive cough, fever, and night sweats. Over the next month, he had an 8-pound weight loss. [wwwnc.cdc.gov]
Respiratory symptoms may consist of cough, sputum production, haemoptysis, or dyspnoea and can be secondary to various respiratory tract or parenchymal diseases [ 4, 47 ]. [karger.com]
Gastrointestinal
- Loss of Appetite
Some people may have mild symptoms, while others have severe problems: Cough, sometimes with blood Fatigue Fever Large amount of mucus Loss of appetite or weight Night sweats Shortness of breath Other symptoms include wheezing, chest pain, and repeat [webmd.com]
They are: Coughing Fever Fatigue Loss of Appetite Trouble Breathing Weight Loss Night Sweats Because these symptoms are so common, hot tub lung is often misdiagnosed as anything from bronchitis to asthma to tuberculosis. [swimuniversity.com]
[…] of appetite or weight, fevers, or night sweats. [medicinenet.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]
Such symptoms include cough, fatigue, shortness of breath (dyspnea), coughing up of blood (hemoptysis), excessive mucus (sputum) production, fever, night sweats, loss of appetite, and unintended weight loss. Wheezing and chest pain may also occur. [rarediseases.org]
Jaw & Teeth
- Metallic Taste
Table 1 Medications and drug combinations used to treat M. avium complex pulmonary infection Treatment regimen Drugs Doses and schedule Potential side effects Daily three-drug regimen Clarithromycin 500 mg BID GI intolerance (including metallic taste) [academic.oup.com]
Ears
- Tinnitus
[…] of saliva, urine and tears Staining of soft contact lenses GI upset ( nausea, vomiting or diarrhea ) Fever and a rash Hepatitis Flu-like symptoms streptomycin, amikacin (Amikin), tobramycin (Tobi) Dizziness or Vertigo Hearing loss Ringing in ears ( tinnitus [medicinenet.com]
Workup
In cases of lung infection, a diagnostic workup will include a chest x ray and tests on discharges from the respiratory passages (sputum). [medical-dictionary.thefreedictionary.com]
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]
Microbiology
- Mycobacterium Chelonae
Objective To compare the demographics, clinical features, susceptibility patterns, and treatment for skin and soft tissue infections due to Mycobacterium fortuitum and Mycobacterium chelonae or Mycobacterium abscessus. [jamanetwork.com]
Treatment of mycobacterium avium and mycobacterium chelonae is difficult. Effective treatment requires three to four antibiotics given at once, sometimes intravenously. [sciencedaily.com]
Some of those causing atypical mycobacterial infections include: Mycobacterium avium-intracellulare Mycobacterium kansasii Mycobacterium marinum Mycobacterium ulcerans Mycobacterium chelonae Mycobacterium fortuitum Mycobacterium abscessus Mycobacterium [dermnetnz.org]
Mycobacterium avium-intracellulare Mycobacterium kansasii Mycobacterium marinum Mycobacterium ulcerans Mycobacterium chelonae Mycobacterium fortuitum Mycobacterium abscessus Any individual may develop Atypical Mycobacterial Infections; although, the [dovemed.com]
[…] parascrofulaceum Mycobacterium xenopi Mycobacterium chelonae : pulmonary Mycobacterium chelonae infection Mycobacterium simiae Mycobacterium abscesssus : pulmonary Mycobacterium abscessus infection 2 Risk factors The organisms have a predilection for [radiopaedia.org]
Treatment
Treatment Treatment of NTM pulmonary infection varies depending on the species of mycobacterium. [academic.oup.com]
Prognosis
Prognosis The prognosis is good with proper medical and surgical treatment. [patient.info]
Treatment and prognosis Detailed guidelines on the management approach are available 12. [radiopaedia.org]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Hot tub lung: an intriguing diffuse parenchymal lung disease Abstract In pulmonary medicine, identical pathogenesis due to varied etiological agents can present with indistinguishable clinical presentation, and produce similar laboratory and radiological [ajol.info]
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]
The etiology of these infections is unknown, but it is most likely due to direct implantation or contamination of surgical instruments. [ncbi.nlm.nih.gov]
(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
O'Brien RJ, Geiter LJ, Snider DE., Jr The epidemiology of nontuberculous mycobacterial diseases in the United States. Results from a national survey. [ncbi.nlm.nih.gov]
Based on our review, we suggest two sets of modifications for epidemiologic and clinical studies. [journals.plos.org]
For several NTM species, environmental sources have been linked epidemiologically to cases of disease ( 15 - 20 ). [wwwnc.cdc.gov]
Epidemiology of infection by nontuberculous mycobacteria. VI. Identification and use of epidemiologic markers for studies of Mycobacterium avium, M. intracellular, and M. scrofulaceum. Am Rev Respir Dis 1986;134:39–43. PubMed Google Scholar 24. [link.springer.com]
To identify imaging and epidemiological features that can help to distinguish ATB infection from Mycobacterium tuberculosis (MTB) infection. Epidemiology Mycobacteria that cause human disease can be divided into two broad groups. [epos.myesr.org]
Pathophysiology
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]
In contrast, most patients could be easily classified as having primary or secondary disease, and these categories are more likely to facilitate better understanding of pathophysiology. [journals.plos.org]
Mycobacterium peregrinum can result in skin infections. [2] Pathophysiology Infections with atypical mycobacteria usually occur in immunocompromised hosts due to host immunity and resistance factors. [emedicine.medscape.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]
Prevention
Currently, there no consensus on prevention among NTM experts. [medicinenet.com]
The great thing about this disease is that it is very easy to prevent. All it takes is a little work from you. The main way to prevent these types of infections is to properly clean your hot tub and its filters on a regular basis. [swimuniversity.com]
(November 6, 2017) Centers for Disease Control and Prevention. CDC Features: Pneumonia can be prevented—vaccines can help. Available online at https://www.cdc.gov/Features/Pneumonia/. Accessed on September 8, 2018. [labtestsonline.it]
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]
Specific prevention options for Atypical Mycobacterial Infections depend on the infecting species type. [dovemed.com]