Clinical Features of Pulmonary Disease Caused by Rapidly Growing Mycobacteria: An Analysis of 154 Patients

Abstract

The role of rapidly growing mycobacteria (RGM) as pulmonary pathogens has been unclear. We identified 154 cases of lung disease caused by RGM using the microbiologic and radiographic criteria of the American Thoracic Society (ATS) and availability of the causative organism for study. More than one third of patients had positive lung biopsy cultures. Patients were predominantly white (83%), female (65%) nonsmokers (66%), and they had prolonged periods from onset of symptoms to diagnosis of their disease. Cough was an almost universal presenting symptom, whereas constitutional symptoms became more important with progression of disease. Upper lobe infiltrates were most common (88%), with 77% of patients developing bilateral disease. Cavitation was present in only 16% of the patients. Specific underlying diseases were infrequent, but they included previously treated mycobacterial disease (18%), coexistent Mycobacterium avium complex (8%), cystic fibrosis (6%), and gastroesophageal disorders with chronic vomiting (6%). The majority of isolates (82%) were M. abscessus (formerly M. chelonae subsp. abscessus). Effective treatment for M. fortuitum long disease was accomplished with drug therapy, whereas surgical resection of localized disease was the only effective long-term therapy for M. abscessus. Although the disease was generally slowly progressive, 21 of 154 (14%) patients died as a consequence of progressive RGM lung disease and respiratory failure. RGM should be recognized as a cause of chronic mycobacterial lung disease, and respiratory isolates should be assessed carefully.

Rare case of Mycobacterium nebraskense presenting as asymptomatic cavitary lung lesion

“…NTM infection has been also reported in women without clearly recognized predisposing factors as in our case [10]. …”

Micobacteriosis diseminada con compromiso de válvula aórtica protésica: primer caso de Mycobacterium peregrinum de tipo III reportada en Colombia

“…Rapidly growing mycobacteria are not usually pathogenic for humans but they can cause several type of infections including skin and soft tissue infections, osteomyelitis, lymphadenitis, disseminated disease, meningitis, postsurgical wound infections, infections of prostethic devices, and chronic lung disease (3)(4)(5)(6)(7)(15)(16)(17)(18). Some cases have been described in Colombia (8,11).…”

“…In clinical conditions, rapidly growing mycobacteria have been related to skin and soft tissue infections (frequently postsurgical wound infections), pulmonary disease, and colonization of implanted materials such as prosthetics, catheters and sutures; these infections could result in sepsis and disseminated disease (3)(4)(5)(6)(7). Clinical cases of environmental opportunistic mycobacteria, including rapidly growing mycobacteria, have been reported in Colombia (8)(9)(10)(11).…”

Successful Treatment with Pneumonectomy for Pulmonary Mycobacterium Abscessus Infection

“…Most of these infections are slowly progressive, but in some cases there is a rapidly progressive clinical course (1). Here (Fig.…”

“…Griffith et al (1) (9). Consequently, for a localized disease that tends to be resistant to antimicrobial agents, surgical lung resection can be effective in producing long-term conversion of sputum culture to negative (10).…”