PMID: 11339476May 8, 2001Paper

The impact of nontuberculous mycobacteria on management of presumed pulmonary tuberculosis

Infection
R van CrevelJ W van der Meer

Abstract

The presence of nontuberculous mycobacteria (NTM) in sputum or bronchial washings may cause diagnostic problems which affect clinical management. In a retrospective analysis of 135 patients in a Dutch tuberculosis center, patients with NTM isolates were thoroughly investigated. Colonization or contamination by NTM was differentiated from true lung disease. 25 HIV-seronegative and two HIV-seropositive patients with NTM were identified. NTM were a likely cause of disease in only 14 (52%) patients. In 15 (55%), their presence led to preliminary diagnosis and treatment of tuberculosis. Unnecessary or inappropriate treatment was instituted in 17 (63%) patients with NTM. In two patients, detection of NTM in sputum also led to delay in diagnosing malignant disease. In this series, NTM in sputum or bronchial washings poorly reflected disease and often led to diagnostic and therapeutic errors. Although it is common knowledge that the presence of NTM should be considered in smear-positive patients, this apparently is a diagnostic pitfall in clinical practice. Reliable DNA-based techniques and better communication between physicians and microbiologists may improve management of suspected mycobacterial infections.

Citations

Aug 2, 2002·Diagnostic Microbiology and Infectious Disease·Isik Somuncu JohansenVibeke Østergaard Thomsen
May 1, 2002·Current Opinion in Pulmonary Medicine·Alimuddin Zumla, John Grange
Aug 7, 2007·American Journal of Respiratory and Critical Care Medicine·Jakko van IngenDick van Soolingen
Feb 6, 2007·American Journal of Respiratory and Critical Care Medicine·David E GriffithUNKNOWN Infectious Disease Society of America
Mar 8, 2008·Emerging Infectious Diseases·Jakko van IngenDick van Soolingen
Nov 21, 2008·Journal of Clinical Laboratory Analysis·Sung Weon RyooSeongman Kang
Feb 14, 2012·Rapid Communications in Mass Spectrometry : RCM·E CrespoF J M Harren
May 27, 2009·Respiratory Medicine·Chun-Ta HuangUNKNOWN Tami Group
Aug 29, 2013·Revista Da Sociedade Brasileira De Medicina Tropical·Andrea Santos LimaHaiana Charifker Schindler
Jul 3, 2002·Clinics in Chest Medicine·Alimuddin I Zumla, John Grange
Mar 31, 2009·International Journal of Systematic and Evolutionary Microbiology·Jakko van IngenDick van Soolingen

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