Expanding spectrum of pulmonary disease caused by nontuberculous mycobacteria.

Abstract

The clinical and radiographic features of 35 patients with nontuberculous mycobacterial (NTMB) pulmonary infections were reviewed. Radiographs of half the patients showed the pattern of cavitary upper-lobe infiltrates typical of reactivation tuberculosis; those of the other half had a radiographic pattern characterized by patchy, nodular infiltrates without an upper-lobe prevalence. Approximately half of the latter group showed multiple small cavities resembling those seen in bronchiectasis. These results suggest that studies in which the diagnosis of NTMB infection has been made primarily from sputum cultures may have been biased toward detecting cavitary disease. The spectrum of pulmonary disease caused by NTMB appears to be larger than previously appreciated. An enhanced awareness of alternate presentations of NTMB infections may result in earlier diagnosis.

CT findings of pulmonary non-tuberculous mycobacterial infection in non-AIDS immunocompromised patients: a case-controlled comparison with immunocompetent patients

“…It has been reported that the upper lobe cavitary and the nodular bronchiectatic forms are responsible for most NTM infections in immunocompetent patients [19][20][21][22][23][24]. The cavitary form is usually seen in older, white males with underlying chronic pulmonary disease.…”

“…The cavities are usually small and thin walled. The nodular bronchiectatic form is usually seen in middle-aged or older females with no predisposing factors [14,19,25,26]. CT findings of the nodular bronchiectatic form include small centrilobular nodules with bronchiectasis, usually occurring in the same lobe [13,23,24,[27][28][29][30][31].…”

Pulmonary Mycobacterium Avium Disease with a Solitary Pulmonary Nodule Requiring Differentiation from Recurrence of Pulmonary Adenocarcinoma

“…Regarding radiological findings for pulmonary MAC disease, Albelda et al noted that alveolar infiltration, and nodular, cavitary lesions were characteristic (8). Otherwise, Tanaka et al reported that the transitional pattern of pulmonary MAC disease was initially characterized by subpleural multiple small nodules and secondary bronchial wall thickening and dilatation (9).…”

Chest case of the day. Mediastinal abscess.

“…In one series,disease was localized to only the right middle lobe on lingula in 20% of patients [5]. In another series, 50% of patients had small, thin-walled structures resembling those seen in bnonchiectasis [2]. Both series used only plain chest radiognaphs for imaging evaluation.…”