Non-tuberculous Mycobacterial Infection Flashcards Preview

Pulmonary > Non-tuberculous Mycobacterial Infection > Flashcards

Flashcards in Non-tuberculous Mycobacterial Infection Deck (22):
1

mesotherapy

a cosmetic medicine treatment

multiple injections of pharmaceutical and homeopathic medications, plant extracts, vitamins, and other ingredients into the subcutaneous fat

allegedly targets fat cells, inducing lipolysis, rupture, and cell death among adipocytes

2

Nontuberculous Mycobacteria (NTM)

>/= 125 NMT species

no latent infection

clinical presentation include granulomatous pneumonia or bronchiectasis

3

group I NTM

photochormogens

M. kansasii

M. marinum

4

group II NTM

scotochromogens

M. xenopi

5

group III NTM

nophochromogens

M. avium

M. intracellulare

often called the MAC (M. avium complex) because the two strains are hard to differentiate

6

group IV NTM

rapid growers

M. fortuitum

M. chelonae

M. abscessus

7

rapidly growing mycobacteria

growth on agar plates within 7 days

includes M. fortuitum, M. chelonae, M. abscessus

amny grow best at 30 degrees C, no special nutritional requirements

8

intermediately growing mycobacteria

grows in 7-10 days

includes M. marinum and M. gordonae

M. marinum grows best at 28-30 degrees C

M. gordonae prefers 35-37 degrees C

9

slowly growing mycobacteria

growth in > 7 days

includes MAC, M. kansasii

some species require nutritional supplementation of routine media

most grow best at 35-37 degrees C

10

source of NTM infection

environmental, not other humans

water- fresh, salt, domestic, hot tubs, metal-working fluids

soild - 80% of soil samples in the SE U.S.

nocosomial sources

11

common NTM causes of chronic bronchopulmonary disease

MAC, M. kansasii, M. chelonae-abscessus

12

common NTM causes of disseminated infection

MAC

13

common NTM causes of skin abscesses

M. marinum, M. chelonae-avscessus, M. fortuitum

14

clinical diagnostic criteria for NTM lung disease

pulmonary symptoms, nodular or cavitary opacities on chest radiograph

CT scan that shows multifocal bronchiectasis with multiple small nodules

and

exclusion of other diseases

15

microbiologic criteria for diagnosis of NTM lung disease

>/= 2 positive culture results from sputum

or

positive culture results from bacterial wash or lavage

or

transbronchial or other lung biopsy showing granulomatous inflammation or +AFB and positive culture for NTM

16

Mycobacterium avium complex (MAC)

includes two closely related organisms M. avium and M. intracellulare

organism common in many environmental sites such as water, soil, and animals

probably acquired by inhalation or ingestion

no person-to-person spread

17

major disease syndromes for MAC

pulmonary disease

disseminated disease (in HIV/AIDS)

cervical lymphadenitis

18

Hot-tub lung

a hypersensitivity reaction to inhaled MAC and not an invasive infection

19

Lady Windemere Syndrome

right middle lobe or lingular bronchiectasis

often found in white women in the 50s or 60s

usually taller and thinner women

consists of years of nagging intermittent cough and fatigue

often comes with scoliosis and cystic fibrosis transmembrane condutance gene mutation

20

MAC treatment

clarithromycin (or azithromycin) plus rifampin (or rifabutin) plus ethambutol x12-18 months

alternative agents are fluoroquinolones, clofazimine, and linezolid

surgical resection - may be useful when medical therapy fails

21

Mycobacterium kansasii

pulmonary infection mimics pulmonary TB

acquired from the environment

not transmitted from person-to-person

22

treatment for M. kansasii infections

isoniazid, rifampin, and ethambutol for >/= 18 months (>/= 12 months after respiratory cultures are negative)