NTM Flashcards
what are the classifications of NTM using the Runyon system ?
group 1 - slow growing, pigment producers in light
group 2 - slow growing, pigment producers without light
group 3 - slow growing, non pigment producers
group 4 - fast growing
what are thee hhost dderived factors ?
pre existing lung disease
trauma surgery
immunodeficiencies
what surgery is associated with atypical mycobacterial infections ?
breast prosthesis
what are the environmental factors associated with NTM ?
tap water
cockroaches - HAP NTM
what are the associated immunodeficiencies associated with NTM infection ?
INF-IL12
acquired disorders - HIV , transplant recipient, immunosuppressive drugs
what are the most common NTM species causing human disease ?
slow growers :
- M.avium complex
- M. Kansasii
rapidly growing :
- M.abscessus typee 4
what type of patient is associated with NTM ?
more common in men
more common in older patients
what is the predominant NTM in children ?
cervical lymphadenitis
due to MAC and M.scrofulaceum
what are the four clinical syndromes associated with NTM ?
pulmonary disease
lymphadenitis
skin or soft tissue disease
disseminated disease
what is the most common symptom reported in NTM ?
fever
what is the most common form of localized NTM infection in HIV negative host ?
chronic pulmonary disease
what are the two different findings in chest imaging in association with NTM ?
1- fibro cavitary lesions
2- nodular bronchiectatic
where is the affectioon with fibro ccavity lesions ?
upper lobes
what to fibro cavity lesions of the upper lobe in NTM resemblee ?
TB
where is the affection in nodular bronchiectatic form ?
right middle lobe
lingular segment of left upper lobe
what are the requirements for a diagnosis of pulmonary disease of NTM ?
radiological criteria ; all required
1- pulmonary sympt
2- cavitation on x ray or HRCT
3- exclusion of other diagnosis
microbiological criteria : only one required
1- two positive sputum sample
2- one positive bronchial wash or lavage culture
3- other evidence of NTM as lung biopsy
who gets lymmphadenitis in association with NTM ?
immunoccomprromised children , especially girls
what is the most common presentation of lymphadenitis ?
isolated unilateral cervical adenitis
what is the differential diagnosis of cervical adenitis of NTM ?
tuberculous adenitis
what is the most common and the second most common causative organism in cervical adenitis ?
MAC
M.scrofulaceum
which lymph nodes are affected with M.scrofulaceum ?
submaxillary and submandibular lesion
what is the treatment of uncomplicated NTM lymphadenitis ?
surgical resection
when does visceral disseminated disease happen, and what is the most common causative organism ?
exclusively in immunocompromised patients
MAC is the most common
what is the most common organism associated with visceral disseminated disease in non HIV patients ?
rapidly growing mycobacterium
as well as M. kansasii & M. haemophilum
what does the skin and soft tissue disease present as ?
following the local blood or lymphatic vessels
what are the two entities associated with NTM SSTI ?
fish tank granuloma - m.marinum
buruli ulcer - m.ulcerans
what is the optimal method for the diagnosis of NTM SSTI ?
culture of a tissue specimen
what is the treatment for MAC ?
macrolide
ethambutol
rifampcin
for 12 months
what is the treatment for M.kansasii infection ?
rifampin
ethambutol
isoniazid
pyridoxine
for 12 months
what is the most common presentation of NTM in HIV patients ?
visceral disseminated disease
what is the problem of using acid fast bacilli staining ?
cannot differentiate between NTM and TBB
what is the staining method used for NTM ?
fluorochrome technique
