Development of infection with non-tuberculous mycobacteria in the right lung lung (B). Kwon YS, - Korean J. Intern. With. (2012). CC BY-NC 3.0
Contents
Definition
Mycobacteria are a group of bacteria that cause various diseases. Some may cause tuberculosis (TB)while others are referred to as non-tuberculous mycobacteria.
- Infection with most commonly occurs among people who have weakened immune system, as in the treatment of rheumatic connective tissue disorders, vasculitides og joint diseases (arthritis) with immunosuppressive drugs and HIV infection. People with chronic lung diseases are also at risk.
- Mycobacteria can cause infection in some joints or vertebrae (Septic arthritis), but other manifestations are more common.
Mycobacterium avium complex, MAC is the most common non-tuberculous infection with mycobacteria that attacks lungs. MAC consists of several types of mycobacteria.
Contamination
Frequently infect bacteria from impure water or water vapor. Aquarium infections (both freshwater and saline) occur (aquariumgranuloma). From an infection, it takes 2-XNUM weeks before any infection breaks out (latency). Not contagious between people.
Non-tuberculous mycobacterial left shoulder joint infection. Murdoch DM, 2007. CC BY 2.0
Symptoms
- Chronic wounds
- Erythema nodosum-like granulomatous nodules on hands and forearms in aquarium granules (M. marinum)
- Swollen, not painful lymph node on the neck (most often children)
- Chronic joint inflammation (septic arthritis) with X-ray changes
- Fever (38-39 degrees)
- Night sweats
- Pulmonary symptoms (if pneumonia)
- Coughing with mucus formation can be blood mixed (hemoptysis)
- Heavy breath at load
- Stomach ache
- Diarrhea
- Weight Loss
Laboratory tests
- Anemia (low "blood percentage")
- Increased alkaline phosphatase (ALP) and lactate dehydrogenase (LD) in blood samples
- Increased CRP and sedimentation rate (ESR)
Diagnosis
- CT examination of lungs
- Most often in the lungs overlaps (as opposed to part rheumatic lung disease)
- Nodes and fibrosis (fibronodular form)
- Caverns (fibro-carvernous form)
- Bronchiectasis (Nodular bronchial shape)
- Sampling by bronchoscopy (Lung investigation) and culturing or by lymph node biopsy
- Bacteria can in some cases be detected directly by microscopy
- Cultivation from tissue or joint fluid
- Blood tests for tuberculosis detection (IGRA test) are usually normal (except for M. Kansasii, M. marinum and M.zulgai)
Treatment
A specialist (pulmonary, infectious) should consider whether treatment is needed and, if necessary, choose the medication.
- Different combination with different antibiotics that should contain azithromycin or clarithromycin
- Long-term treatment
Literature
- Two H, XNUM
- Part R, 2018 (MAC and pneumonia)
- Bi S, 2015 (Osteomyelitis)
- Henkle E, 2015
- Cross I, 2019 (Akvariegranulom)
- Wikipedia
Opportunistic infections, BINDEVEVSSYKDOMMER.no
