NTM Flashcards
What is the most common presentation of Nontuberculosis Mycobacterial Disease?
Cervical lymphadenitis
Other presentations include skin and soft tissue infections.
In which setting does pulmonary NTM disease most often occur?
In the setting of preexisting lung disease
Most commonly associated with cystic fibrosis (CF).
What may cause disseminated NTM disease?
Immune compromise
Often due to HIV/AIDS or a variety of rare conditions.
Which complex is the most commonly encountered NTM?
Mycobacterium avium complex (MAC)
Includes species like M. avium, M. intracellulare, and M. chimaera.
What is the prevalence of Nontuberculosis Mycobacterial Disease in the general population?
27.9 cases per 100,000 population
Rarely a cause of death.
What percentage of cystic fibrosis patients are affected by Nontuberculosis Mycobacterial Disease?
6%–13%
Patients infected with MABSC are often younger and may include children.
What is the predominant risk factor for Nontuberculosis Mycobacterial Disease?
Human Immunodeficiency Virus Infection/Acquired Immune Deficiency Syndrome
CD4 cell count < 50 cells/mm.
Nearly all acquisition of NTM by children occurs from _______.
Environmental sources
Includes soil, water, dust, and aerosols.
What are common clinical manifestations of Nontuberculous Mycobacteria Pulmonary Disease?
- Chronic cough
- Sputum production
- Radiographic signs (pulmonary nodules, tree-in-bud opacities)
- Bronchiectasis
- Cavitation
What are the clinical criteria for diagnosing Nontuberculous Mycobacteria Pulmonary Disease?
Patient must meet both microbiologic and clinical criteria
Appropriate exclusion of other diagnoses is required.
What microbiologic criteria must be met for diagnosing Nontuberculous Mycobacteria Pulmonary Disease?
2 or more positive sputum cultures for the same NTM species
A single positive culture from a bronchial wash or tissue biopsy is also acceptable.
True or False: Making the diagnosis of NTM pulmonary disease requires initiation of treatment.
False
Diagnosis does not necessarily require treatment initiation.
What is the most common form of extrapulmonary Nontuberculous Mycobacteria Disease?
Lymphadenitis (cervical LN)
Skin and soft-tissue infections are less common.
What are the symptoms of disseminated MAC disease?
- Fever
- Night sweats
- Abdominal pain
- Diarrhea
- Weight loss
For a diagnosis of disseminated NTM disease, how many cultures are sufficient?
A single culture from a wound or blood
Treatment should be initiated immediately.
How long should Nontuberculous Mycobacteria Pulmonary Disease be treated?
12 months beyond culture conversion
Culture conversion is defined as 3 consecutive negative cultures.
What is the initial treatment regimen for noncavitary NTM lung disease due to MAC?
- Azithromycin
- Rifamycin
- Ethambutol
Why is azithromycin preferred for treating MAC disease?
Once daily dosing and reduced interactions with rifampin
Compared to clarithromycin.
What is the treatment regimen for Mycobacterium kansasii pulmonary disease?
- Isoniazid
- Rifampin
- Ethambutol
Treatment is daily for at least 12 months.
What complications arise in the treatment of Mycobacterium abscessus species complex (MABSC)?
Significant levels of in vitro resistance and need for intravenous antibiotics
Common adverse reactions and poor treatment outcomes are also concerns.
What types of surgical treatment options are available for NTM lung disease?
- Pneumonectomy
- Lobectomy
- Segmentectomy
Sometimes performed to improve treatment outcomes.
What are some alternative drugs for treating NTM?
- Fluoroquinolones
- Clofazimine
- Inhaled amikacin
- Linezolid
- Bedaquiline
What is noted about outcomes associated with NTM in children?
Outcomes are not well reported in the literature.
