PULMONARY DISEASE CAUSED BY MYCOBACTERIUM XENOPI IN AN AUSTRALIAN MAN

Introduction. Human nontuberculous mycobacteria (NTM) or environmental mycobacteria related disease is on increase. Risk factors are unclear and associations are observed in relation to climate differences, population density, or host susceptibility. With availability of molecular techniques for NTM identification, we faced emergence of NTM pulmonary cases. The work is an invitation more to colleagues to enroll the rare NTM cases into large study group. Case report. During an episode of productive cough and fever in a 73-year-old HIV-negative man smoker with minimal sequellae of pulmonary tuberculosis, sputum smears were acid fast bacilli positive on direct microscopy. The L?wenstein- Jensen culture results were positive with 20, 30 and 50 colonies, and molecular identification confirmed Mycobacterium xenopi (M. xenopi). Standard chest radiography showed no signs of active lesions. Examination was completed with bronchoscopy and thorax multi-slice computed tomography (MSCT). Cavitary lesions in the apico-posterior part of the left upper lobe (LUL) were detected. Under treatment (rifampicin, ethambutol, clarithromycin) sputum conversion was achieved, but irregular cavitation in the LUL remained at MSCT after 6 and after 12 months with signs of minimal regression. Patient?s general condition only mildly improved and asthenia remained. Observed risk factors were previous pulmonary disease, tobacco smoking, malnutrition and prolonged emotional stress. Conclusion. M. xenopi related pulmonary disease, difficult to cure and with uncertain prognosis, is a challenge in clinical practice. Since treatment is still controversial, more randomized clinical trials are needed. Current international multicentre approach might be a good option for a larger sample size and development of new guide.

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Clinical outcomes in Mycobacterium xenopi versus Mycobacterium avium complex pulmonary disease: A retrospective matched cohort study

Respiratory Medicine ◽

10.1016/j.rmed.2020.105967 ◽

2020 ◽

Vol 167 ◽

pp. 105967 ◽

Cited By ~ 1

Author(s):

Ahmad Zaheen ◽

Takashi Hirama ◽

Matty Mehrabi ◽

Sarah K. Brode ◽

Theodore K. Marras

Keyword(s):

Cohort Study ◽

Pulmonary Disease ◽

Clinical Outcomes ◽

Mycobacterium Avium ◽

Mycobacterium Avium Complex ◽

Matched Cohort ◽

Matched Cohort Study ◽

Mycobacterium Xenopi

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Treatment of Nontuberculous Mycobacterial Pulmonary Disease: An Official ATS/ERS/ESCMID/IDSA Clinical Practice Guideline

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1125 ◽

2020 ◽

Vol 71 (4) ◽

pp. 905-913 ◽

Cited By ~ 7

Author(s):

Charles L Daley ◽

Jonathan M Iaccarino ◽

Christoph Lange ◽

Emmanuelle Cambau ◽

Richard J Wallace ◽

...

Keyword(s):

Infectious Diseases ◽

Pulmonary Disease ◽

Healthcare Professionals ◽

Mycobacterium Abscessus ◽

Clinical Microbiology Laboratory ◽

Pulmonary Medicine ◽

Assessment Development ◽

Evaluation Approach ◽

Mycobacterium Xenopi ◽

Immunodeficiency Virus

Abstract Nontuberculous mycobacteria (NTM) represent over 190 species and subspecies, some of which can produce disease in humans of all ages and can affect both pulmonary and extrapulmonary sites. This guideline focuses on pulmonary disease in adults (without cystic fibrosis or human immunodeficiency virus infection) caused by the most common NTM pathogens such as Mycobacterium avium complex, Mycobacterium kansasii, and Mycobacterium xenopi among the slowly growing NTM and Mycobacterium abscessus among the rapidly growing NTM. A panel of experts was carefully selected by leading international respiratory medicine and infectious diseases societies (ATS, ERS, ESCMID, IDSA) and included specialists in pulmonary medicine, infectious diseases and clinical microbiology, laboratory medicine, and patient advocacy. Systematic reviews were conducted around each of 22 PICO (Population, Intervention, Comparator, Outcome) questions and the recommendations were formulated, written, and graded using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Thirty-one evidence-based recommendations about treatment of NTM pulmonary disease are provided. This guideline is intended for use by healthcare professionals who care for patients with NTM pulmonary disease, including specialists in infectious diseases and pulmonary diseases.

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Treatment of Nontuberculous Mycobacterial Pulmonary Disease: An Official ATS/ERS/ESCMID/IDSA Clinical Practice Guideline

Clinical Infectious Diseases ◽

10.1093/cid/ciaa241 ◽

2020 ◽

Vol 71 (4) ◽

pp. e1-e36 ◽

Cited By ~ 13

Author(s):

Charles L Daley ◽

Jonathan M Iaccarino ◽

Christoph Lange ◽

Emmanuelle Cambau ◽

Richard J Wallace ◽

...

Keyword(s):

Infectious Diseases ◽

Pulmonary Disease ◽

Healthcare Professionals ◽

Mycobacterium Abscessus ◽

Clinical Microbiology Laboratory ◽

Pulmonary Medicine ◽

Assessment Development ◽

Evaluation Approach ◽

Mycobacterium Xenopi ◽

Immunodeficiency Virus

Abstract Nontuberculous mycobacteria (NTM) represent over 190 species and subspecies, some of which can produce disease in humans of all ages and can affect both pulmonary and extrapulmonary sites. This guideline focuses on pulmonary disease in adults (without cystic fibrosis or human immunodeficiency virus infection) caused by the most common NTM pathogens such as Mycobacterium avium complex, Mycobacterium kansasii, and Mycobacterium xenopi among the slowly growing NTM and Mycobacterium abscessus among the rapidly growing NTM. A panel of experts was carefully selected by leading international respiratory medicine and infectious diseases societies (ATS, ERS, ESCMID, IDSA) and included specialists in pulmonary medicine, infectious diseases and clinical microbiology, laboratory medicine, and patient advocacy. Systematic reviews were conducted around each of 22 PICO (Population, Intervention, Comparator, Outcome) questions and the recommendations were formulated, written, and graded using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Thirty-one evidence-based recommendations about treatment of NTM pulmonary disease are provided. This guideline is intended for use by healthcare professionals who care for patients with NTM pulmonary disease, including specialists in infectious diseases and pulmonary diseases.

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Mycobacterium xenopi and Pulmonary Disease

American Journal of Clinical Pathology ◽

10.1093/ajcp/73.6.826 ◽

1980 ◽

Vol 73 (6) ◽

pp. 826-830 ◽

Cited By ~ 16

Author(s):

June H. Koizumi ◽

Herbert M. Sommers

Keyword(s):

Pulmonary Disease ◽

Mycobacterium Xenopi

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Comparison of the Spectrum of Radiologic and Clinical Manifestations of Pulmonary Disease Caused by Mycobacterium avium Complex and Mycobacterium xenopi

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2013.05.006 ◽

2014 ◽

Vol 65 (3) ◽

pp. 207-213 ◽

Cited By ~ 18

Author(s):

Maria C. Carrillo ◽

Demetris Patsios ◽

Ute Wagnetz ◽

Frances Jamieson ◽

Theodore K. Marras

Keyword(s):

Computed Tomography ◽

Lung Disease ◽

Pulmonary Disease ◽

Clinical Data ◽

Mycobacterium Avium ◽

Mycobacterium Avium Complex ◽

Clinical Manifestations ◽

Ground Glass ◽

Mycobacterium Xenopi ◽

Significant Difference

Aim Mycobacterium xenopi is described with upper lobe cavitation (“fibrocavitary” pattern), whereas the Mycobacterium avium complex (MAC) is described with bronchiectasis and centrilobular nodules (“nodular bronchiectasis”). We retrospectively described and compared computed tomography (CT) chest manifestations of disease caused by MAC and M xenopi. Materials and Methods We reviewed patients who had either MAC or M xenopi lung disease and who had CTs between January 2002 and December 2003. Clinical data were recorded, and the patterns on chest CTs were categorized as “fibrocavitary,” “nodular bronchiectatic,” and “unclassified.” Results There were 74 patients; 50 with MAC and 24 with M xenopi. The patients with MAC were older (mean 69 vs 58 years; P = .007). Patients with M xenopi more often had emphysema (50% vs 20%; P = .02), cavities (46% vs 16%; P = .01), and nodules ≤5 mm (88% vs 58%; P = .02). M xenopi cases more commonly had a fibrocavitary radiologic pattern (33% vs 18%), with no statistically significant difference ( P = .24). MA C was more often associated with a nodular bronchiectatic pattern (68% MAC vs 4% M xenopi; P < .0001). Sixty-three percent of patients with M xenopi had a pattern that was predominantly randomly distributed nodules (11/15 [73%]) or consolidation and/or ground-glass opacities (4/15 [27%]). Conclusion Compared with MAC, patients with M xenopi infection develop more cavities and more nodules, and they less often have a predominant nodular bronchiectatic pattern. Although a predominantly cavitary pattern appears to be more common with M xenopi, the majority of patients with M xenopi had CT patterns of random nodules or consolidation and/or ground-glass opacities rather than classically described findings.

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