Overview of nontuberculous mycobacterial infections in HIV-negative patients
- David E Griffith, MD
David E Griffith, MD
- Professor of Medicine
- University of Texas Health Center at Tyler
Nontuberculous mycobacteria (NTM) species are mycobacterial species other than those belonging to the Mycobacterium tuberculosis complex (eg, M. tuberculosis, Mycobacterium bovis, Mycobacterium africanum, and Mycobacterium microti) and Mycobacterium leprae. NTM are generally free-living organisms that are ubiquitous in the environment. There have been more than 140 NTM species identified.
In broad terms, NTM can cause four clinical syndromes in humans [1,2]:
●Pulmonary disease, especially in older persons with or without underlying lung disease and patients with cystic fibrosis, caused primarily by Mycobacterium avium complex (MAC) and Mycobacterium kansasii.
Other species that cause lung disease include Mycobacterium abscessus, Mycobacterium fortuitum, Mycobacterium xenopi, Mycobacterium malmoense, Mycobacterium szulgai, and Mycobacterium simiae (table 1) . Geography plays a prominent role in the epidemiology of NTM pulmonary disease. M. xenopi is relatively more common in Europe, Great Britain, and Canada, while M. malmoense is relatively more common in Scandinavia and Northern Europe [1,4]. (See "Epidemiology of nontuberculous mycobacterial infections".)
●Superficial lymphadenitis, especially cervical lymphadenitis, in children caused mostly by MAC, Mycobacterium scrofulaceum, and, in northern Europe, M. malmoense and Mycobacterium haemophilum. (See "Overview of disseminated nontuberculous mycobacterial (NTM) infections and NTM bacteremia in children" and "Overview of nontuberculous mycobacterial lymphadenitis in children".)
●Disseminated disease in severely immunocompromised patients (most commonly caused by MAC and less commonly by the rapidly growing mycobacteria [RGM], eg, M. abscessus, M. fortuitum, and Mycobacterium chelonae). (See "Mycobacterium avium complex (MAC) infections in HIV-infected patients" and "Rapidly growing mycobacterial infections in HIV-negative patients".)
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- MYCOBACTERIUM AVIUM COMPLEX
- Pulmonary disease
- - Clinical manifestations
- - Diagnostic criteria
- - Pathogenesis
- Disseminated disease
- - Clinical symptoms and signs
- - Diagnostic cultures
- MYCOBACTERIUM KANSASII
- Clinical features
- RAPIDLY GROWING MYCOBACTERIA
- OTHER NONTUBERCULOUS MYCOBACTERIA