51-Year-Old Man With Fever and Productive Cough

Herberts, Michelle; Bourne, Michael H.; Escalante, Patricio

doi:10.1016/j.mayocp.2019.03.039

Cited by 1 publication

(1 citation statement)

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“…Prior case reports have demonstrated that exposure to such compounds is associated with a variety of pulmonary pathologies, and specifically in NTM 10. Other recent cases have documented NTM infections in patients with underlying pulmonary pathology 11–13. Despite these associations, additional research is needed to study if exposure to specific industrial chemicals may lead to a higher predilection for chronic pulmonary pathology.…”

Section: Discussionmentioning

confidence: 99%

Importance of asking a social history: atypical pulmonary infections and occupational hazards

et al. 2022

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Non-tuberculous mycobacteria (NTM) are ubiquitous in the environment, but NTM infection is limited to individuals with risk factors. We present a case of a 62-year-old man who presented with a 1 year history of cough and shortness of breath. History was notable for significant tobacco use and work as a sandblaster without the use of personal protective equipment. His chest X-ray showed bilateral upper lobe cavitary lesions, which were redemonstrated on chest CT. A sputum Gram stain was positive for acid-fast bacilli, but his tuberculosis QuantiFERON was negative. He was started on empiric tuberculosis treatment. Sputum cultures ultimately returned for Mycobacterium avium intracellulare complex, and treatment was narrowed to azithromycin, rifampin and ethambutol. The case highlights risk factors for NTM infection, notably for this patient, occupational exposures that likely lead to the development of pneumoconiosis. Healthcare providers should ask about occupational history and counsel patients about protection from occupational hazards.

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Section: Discussionmentioning

confidence: 99%