TB/NTM Flashcards
NTM recovered almost exclusively from municipal water sources
M kansasii
M xenopi
M simiae
**NTM are generally resistant to chlorination
Risk factors for disseminated NTM
- cell-mediated immunodeficiency (HIV, steroid use)
- IFNg or IL2 defects
Rapid-Growing NTM
- M abscessus
- M chelonae
- M fortuitum complex
- M immunogenum
- M mucogenicum
- M smegmatis
Slow-Growing NTM
- Photogromogens (demonstrate pigment only in presence of light)
- M kansasii
- M marinum
- Scotochromogens (pigment with or without presence of light)
- M gordonae
- M scrofulaceum
- Nonchromogens (no pigment)
- MAC
- M haemophilum
- M malmoense
- M simiae
NTM a/w metalworking fluid
M immunogenum
NTM a/w lasik
M chelonae
Complications of leprosy
- reversal reaction
- increased warmth, erythema, edema of preexisting lesions
- d/t development of exuberant local T-cell mediated immune response to living or dead bacilli
- permanent nerve damage if left untreated
- can’t occur in tuberculoid form
- erythema nodosum leprosum
- acute new SQ nodules - painful, red, tender
- extensor surfaces of legs and the face
- d/t complement activation following immune complex deposition
disseminated NTM infection in AIDS patient suspected but cultures negative
M genavense
has been implicated in pseudo-outbreaks a/w contaminated scopes
M immunogenum
NTM in equitorial Africa
M ulcerans
Leprosy tx
- PB - dapsone + rifampin x6mos
- MB - dapsone + clofazimine daily x12mos
+ hypoanesthesia
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leprosy (this is lepromatous classification - will be punch bx AFB+)
Classification of leprosy
- Paucibacillary - most common. Bacillary load <1mil, skin bx = AFB negative. <5 skin lesions
- Multibacillary - “lepromatous”, massive bacillary load, skin bx = AFB floridly positive. >5 skin lesions
disseminated fortuitum tx
3rx (including 1 IV) x4-6mos
- macrolides, quinolones, bactrim, doxy (50%)
- IV: aminoglycosides, imipenem, cefoxitin, tigecycline
disseminated chelonae tx
3rx (including 1 IV) x4-6mos
- macrolides, fluoroquinolone, linezolid
- IV: aminoglycosides, imipenem, cefoxitin, tigecycline
***tobra = best for chelonae