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ICC1 > NTM > Flashcards

NTM Flashcards

1
Q

what are the classifications of NTM using the Runyon system ?

A

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

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2
Q

what are thee hhost dderived factors ?

A

pre existing lung disease
trauma surgery
immunodeficiencies

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3
Q

what surgery is associated with atypical mycobacterial infections ?

A

breast prosthesis

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4
Q

what are the environmental factors associated with NTM ?

A

tap water
cockroaches - HAP NTM

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5
Q

what are the associated immunodeficiencies associated with NTM infection ?

A

INF-IL12
acquired disorders - HIV , transplant recipient, immunosuppressive drugs

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6
Q

what are the most common NTM species causing human disease ?

A

slow growers :
- M.avium complex
- M. Kansasii
rapidly growing :
- M.abscessus typee 4

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7
Q

what type of patient is associated with NTM ?

A

more common in men
more common in older patients

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8
Q

what is the predominant NTM in children ?

A

cervical lymphadenitis
due to MAC and M.scrofulaceum

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9
Q

what are the four clinical syndromes associated with NTM ?

A

pulmonary disease
lymphadenitis
skin or soft tissue disease
disseminated disease

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10
Q

what is the most common symptom reported in NTM ?

A

fever

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11
Q

what is the most common form of localized NTM infection in HIV negative host ?

A

chronic pulmonary disease

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12
Q

what are the two different findings in chest imaging in association with NTM ?

A

1- fibro cavitary lesions
2- nodular bronchiectatic

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13
Q

where is the affectioon with fibro ccavity lesions ?

A

upper lobes

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14
Q

what to fibro cavity lesions of the upper lobe in NTM resemblee ?

A

TB

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15
Q

where is the affection in nodular bronchiectatic form ?

A

right middle lobe
lingular segment of left upper lobe

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16
Q

what are the requirements for a diagnosis of pulmonary disease of NTM ?

A

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

17
Q

who gets lymmphadenitis in association with NTM ?

A

immunoccomprromised children , especially girls

18
Q

what is the most common presentation of lymphadenitis ?

A

isolated unilateral cervical adenitis

19
Q

what is the differential diagnosis of cervical adenitis of NTM ?

A

tuberculous adenitis

20
Q

what is the most common and the second most common causative organism in cervical adenitis ?

A

MAC
M.scrofulaceum

21
Q

which lymph nodes are affected with M.scrofulaceum ?

A

submaxillary and submandibular lesion

22
Q

what is the treatment of uncomplicated NTM lymphadenitis ?

A

surgical resection

23
Q

when does visceral disseminated disease happen, and what is the most common causative organism ?

A

exclusively in immunocompromised patients
MAC is the most common

24
Q

what is the most common organism associated with visceral disseminated disease in non HIV patients ?

A

rapidly growing mycobacterium
as well as M. kansasii & M. haemophilum

25
Q

what does the skin and soft tissue disease present as ?

A

following the local blood or lymphatic vessels

26
Q

what are the two entities associated with NTM SSTI ?

A

fish tank granuloma - m.marinum
buruli ulcer - m.ulcerans

27
Q

what is the optimal method for the diagnosis of NTM SSTI ?

A

culture of a tissue specimen

28
Q

what is the treatment for MAC ?

A

macrolide
ethambutol
rifampcin
for 12 months

29
Q

what is the treatment for M.kansasii infection ?

A

rifampin
ethambutol
isoniazid
pyridoxine
for 12 months

30
Q

what is the most common presentation of NTM in HIV patients ?

A

visceral disseminated disease

31
Q

what is the problem of using acid fast bacilli staining ?

A

cannot differentiate between NTM and TBB

32
Q

what is the staining method used for NTM ?

A

fluorochrome technique

ICC1 (50 decks)

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