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Trop Med > Non-TB mycobacterium > Flashcards

Non-TB mycobacterium Flashcards

1
Q

What is the Runyan classification?

A

Runyan classification based on production of pigmentation, whether the pigmentation occurred in darkness or light, and growth rates

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2
Q

Grown in dark develop a pigment?

A

Scotochromogens

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3
Q

Grown in light and produce a yellow pigment?

A

Photochromogens

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4
Q

Name some examples from group I to IV

A

Class I: Photochromogens (M kansasii, M
marinum, M simiae, M asiaticum)
* Class II: Scotochromogens (M scrofulaceum,
M gordonae, M szulgai, M xenopi)
* Class III: Nonchromogenic (M avium-
intracellulare, M terrae, M paratuberculosis)
* Class IV: Rapid Growers (M chelonae, M
abscessus, M fortuitum)

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5
Q

What are the most important non pigmented species fast growers?

A

M abscessus, M fortuitum

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6
Q

What are slow growing NTMs?

A

M. avium complex (MAC, MAI, M. avium-intracellulare)
M. kansasii
M. ulcerans
M. xenopi
M. terrae complex
M. simiae
M. haemophilum
M. szulgai
M. genavensae
M. scrofulaceum
M. malmoense

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7
Q

Intermediately slow growing NTM?

A

M. marinum, M. gordonae

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8
Q

What is often caught in a swimming pool?

A

M. marinum

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9
Q

What are the major clinical syndromes of NTMs?

A

Chronic pulmonary disease
lymphadenitis
Skin and soft tissue

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10
Q

What are the most common NTM causes of pulmonary disease?

A

Mycobacterium avium-intracellulare
M. kansasii,
M. abscessus

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11
Q

What are the common NTM causing lymphadenitis?

A

MAI
M. scrofulaceum
M. malmoense

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12
Q

What are the common causes of NTM causing skin disease?

A

M. marinum
M. chelonae

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13
Q

What causes skeletal disease?

A

MAC/MAI, M. marinum, M. kansasii, M. fortuitum, M.
abscessus, M. chelonae

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14
Q

What NTM causes disseminated infection and in who?

A

HIV

MAI, M. kansasii and M. haemophilum

HIV negative patients - M. abscessus, M. chelonae

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15
Q

What NTM cause line infections/healthcare associated infections?

A

M. fortuitum, M. abscessus, and M. chelonae

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16
Q

Which NTM do Middle age male smokers, often heavy alcohol users get?

A

MAI, M. kansasii

Upper lobe cavitary disease; resembles M. tuberculosis disease

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17
Q

Which NTM do Older nonsmoking females with no apparent underlying disease get?

A

MAC

RML, lingular bronchiectasis (Lady Windermere Syndrome)

18
Q

Which NTM causes Achalasia, chronic vomiting, lipoid pneumonia?

A

M. fortuitum, M. abscessus, MAI

19
Q

What is the most common NTM in South America?

A

M.Kansasii

20
Q

What is the most common NTM in the world?

A

MAC
(includes M. avium-intracellulare)

21
Q

Do you treat everyone with positive NTM on sputum?

A

No!
- Symptomatic
- Aggressive clinically and radiologically

22
Q

What are the public health concerns of NTM?

A

Nil
Non contagious
Live in environment everywhere

23
Q

Most prominent risk factor for MAC?

A

Immunosuppression with CD4 less than 50

24
Q

What is the transmission?

A

Ingestion or inhalation

25
Q

Differentials of Cavitating lesions on CXR?

A

TB
Non-TB mycobacterium
Fungal
Bacterial
Parasitic

26
Q

What are rice bodies? What causes it?

A

Granulomatous infection of tendon sheath

TB
NTM - MAC most common
fungal infection

27
Q

What are globi?

A

Overwhelming bone marrow infiltration with an NTM

28
Q

How does M.Kansasii present?

A

Almost always pulmonary disease, interstitial infiltrates and lobar infiltrates

Can be disseminated disease (in HIV)

Very similar to TB!

29
Q

What is the Rx of M.Kansasii?

A

Same as TB except without the PZA

30
Q

How do you differentiate species of NTM?

A

Culture

31
Q

What is this?

A

M scrofulaceum

Differentials
- TB (more likely)
- M. malmoense

32
Q

In who do you find M.haemophilum?

A

Immunocompromised
Aquatic reservoirs.

33
Q

3 most common mycobacterium

A

M.TB
M.Leprae
M.Ulcerans

34
Q

How do you manage a Buruli ulcer?

A

Clarithromycin and rifampin Surgical excision

35
Q

Which NTM do you get from fresh water esp if an injury?

A

M.marinum

All patients reported contact
with fish tanks at home or work prior to infection.

36
Q

Which NTM do you get from fresh water esp if an injury?

A

M.marinum

All patients reported contact
with fish tanks at home or work prior to infection.

37
Q

Injury in a fish tank, Diagnosis?
Key differential?

A

Infection began as papulonodular lesion on finger or hand in all 8
patients, and remained confined to the skin and lymphatics.
(resembles sporotrichosis).

38
Q

45 year old transplant patient, develops bilateral ulcerative lesions on Lower limbs, works as a farmer. Diagnosis?

A

M. abscessus/chelonae

Commonly found in tap water

Causes skin and soft tissue disease

39
Q

How do you treat M.Kansasii

A

Same as TB minus the PZA

40
Q

How do you treat MAC?

A

Clarith/azith plus rifampicin plus ethambutol (plus amino glycoside in some cases)

Trop Med (49 decks)

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