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Infections caused by Mycobacterium szulgai in humans
J M Maloney1, C R Gregg, D S Stephens
1Department of Medicine, Emory University School of Medicine, Atlanta, Georgia 30303.
Reviews of Infectious Diseases
|November 1, 1987
Summary
Mycobacterium szulgai causes human disease, most commonly pulmonary infections resembling tuberculosis. Effective treatment involves multiple antimycobacterial drugs, with surgery reserved for specific cases like olecranon bursitis.
Area of Science:
- Medical Microbiology
- Infectious Diseases
Background:
- Mycobacterium szulgai, a scotochromogenic species, is increasingly recognized as a human pathogen.
- Limited data exists on the clinical spectrum and treatment of Mycobacterium szulgai infections.
Observation:
- A review of 24 reported cases and analysis of 3 new cases (2 pulmonary, 1 extrapulmonary) were conducted.
- Pulmonary disease, often indistinguishable from Mycobacterium tuberculosis, was the most frequent presentation (18/27 cases).
- Other manifestations included olecranon bursitis (3 cases) and disseminated infections in immunocompromised patients (3 cases).
Findings:
- Mycobacterium szulgai exhibits greater susceptibility to standard antimycobacterial agents compared to other nontuberculous mycobacteria, including the Mycobacterium avium complex.
- Successful treatment of pulmonary M. szulgai infections can be achieved with combination therapy using at least three drugs identified through in vitro susceptibility testing.
- Surgical intervention is generally not required for pulmonary disease but may be beneficial for olecranon bursitis.
Implications:
- This study highlights Mycobacterium szulgai as a significant, treatable cause of mycobacterial disease.
- Understanding the clinical features and antimicrobial susceptibility patterns of M. szulgai can guide effective therapeutic strategies.
- The findings support the use of multi-drug regimens based on susceptibility testing for M. szulgai infections, potentially avoiding unnecessary surgery.