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Pulmonary non-tuberculous mycobacterial disease
M L Plit1, M Woolf, G B Miller
1Department of Medicine, J.G. Strijdom Hospital, Johannesburg.
South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
|September 3, 1988
Summary
Pulmonary non-tuberculous mycobacterial disease presents similarly to tuberculosis, complicating diagnosis. Early sputum culture and drug resistance testing are crucial for accurate identification and management.
Area of Science:
- Pulmonary Medicine
- Infectious Diseases
- Microbiology
Background:
- Pulmonary non-tuberculous mycobacterial (NTM) disease is an emerging health concern.
- Distinguishing NTM from tuberculosis (TB) is clinically challenging due to overlapping symptoms.
Observation:
- Clinical and radiological findings in NTM disease were largely indistinguishable from TB.
- A few thin-walled cavities were noted as potentially more suggestive of NTM.
- Predisposing factors like prior lung disease and bronchiectasis were present in some patients, but 5 had no prior lung issues.
Findings:
- Confirmed 3 and identified 7 possible cases of pulmonary NTM disease.
- Identified known risk factors for NTM, but also noted cases without pre-existing lung conditions.
- Highlighted treatment challenges due to the chronic and indolent nature of NTM infections.
Implications:
- Prolonged, aggressive polypharmacy is generally not indicated for NTM disease.
- Recommend at least two sputum specimens for culture and drug resistance testing upon suspicion.
- This approach aids in differentiating colonization from infection and guides rational patient management.