Mycobacterium xenopi pulmonary infection: evaluation with CT

Area of Science:

• Medical Imaging
• Infectious Diseases
• Pulmonology

Background:

• Mycobacterium xenopi is an atypical mycobacterium that can cause pulmonary infections.
• Pulmonary infections caused by M. xenopi often present with nonspecific symptoms, making diagnosis challenging.
• Computed tomography (CT) plays a crucial role in evaluating pulmonary abnormalities.

Purpose of the Study:

• To characterize the CT imaging features of Mycobacterium xenopi pulmonary infection.
• To correlate CT findings with clinical and microbiological data.

Main Methods:

• Retrospective review of CT scans from eight immunocompetent patients diagnosed with M. xenopi infection.
• Analysis of CT findings by two independent observers reaching consensus.
• Inclusion of patients meeting American Thoracic Society criteria for M. xenopi infection.

Main Results:

• Seven out of eight patients presented with upper lobe cavitary disease, including masses, nodules, and consolidation with cavities.
• All patients showed adjacent lung architectural distortion, fibrosis, and centrilobular nodules indicative of endobronchial spread.
• Seven patients had a history of chronic obstructive pulmonary disease (COPD), confirmed by CT, and four had associated pleural disease.

Conclusions:

• Mycobacterium xenopi pulmonary infection predominantly affects the upper lobes in patients with pre-existing pulmonary emphysema.
• CT findings typically include cavitary opacities, fibrosis, and signs of endobronchial spread.
• CT imaging is valuable for identifying characteristic patterns of M. xenopi infection, aiding in diagnosis and management.