Infection with mycobacterium avium complex in patients without predisposing conditions

Article Abstract:

Mycobacterium avium, a type of bacteria which causes a lung infection similar to tuberculosis, usually affects patients with lung disease or immune deficiencies, such as AIDS patients and elderly men with underlying chronic lung diseases. However, it can also occur in people without any predisposing factors. To determine the incidence and characteristics of this disease in patients without predisposing factors, records of 21 patients were reviewed over a 10-year period. Common symptoms were persistent cough with large amounts of sputum, without associated fever or weight loss. It was found that the correct diagnosis was delayed for an average of 25 weeks and the infection occurred mostly in women, with the mean age being 66 years old. Antibiotic therapy was initially effective, but when the drugs were stopped eight patients had a relapse of the infection. X-ray films revealed progressive nodules which appeared opaque. Four patients died from the infection. It is suggested that because of the resistent nature of this type of bacteria, combination antibiotic therapy should be administered.

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Mycobacterium avium complex and the normal host

Article Abstract:

Mycobacterium avium, a type of bacteria that causes a lung infection similar to tuberculosis, typically occurs in acquired immunodeficiency syndrome (AIDS) patients and patients with chronic lung diseases. However, there is growing concern over the incidence of infection in people having no predisposing factors, particularly women. The women have been found to have abnormal chest dimensions, scoliosis (spinal deformity) or heart valve defects which somehow make them more susceptible to the infection. It is also possible that the organism itself is becoming more virulent. The organism is thought to be acquired from the environment, possibly inhaled. A study by Prince et al. reviewed the incidence of M.avium infections and documented four deaths as a result of the infection. This suggests that the disease is not as indolent as previously suspected and multidrug therapy is warranted. Theories proposed that other disorders such as connective-tissue disease may predispose women to the infection need to be examined.

editorial

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Treatment of 171 patients with pulmonary tuberculosis resistant to isoniazid and rifampin

Article Abstract:

Some patients suffering from multidrug-resistant tuberculosis may be difficult to treat. Drug-resistant tuberculosis is caused by a strain of Mycobacterium tuberculosis that is resistant to anti-tuberculosis drugs. A study examined the treatment of 171 patients between 17 and 79 years old suffering from pulmonary tuberculosis resistant to treatment with rifampin and isoniazid. All the patients were treated with an average of six anti-tuberculosis drugs, and all were infected with a strain of Mycobacterium tuberculosis resistant to an average of six anti-tuberculosis drugs. Of 134 patients for whom the outcome of treatment was known, 87 (65%) responded to treatment with anti-tuberculosis drugs and 47 (35%) failed to respond to treatment. Fourteen percent of the patients who responded to treatment suffered a relapse five to 62 months after beginning treatment. Almost half of those who relapsed or did not respond to treatment died.

Health aspects, Care and treatment, Drug therapy, Tuberculosis, Drug resistance in microorganisms, Microbial drug resistance, Antitubercular agents

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