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Section 3. Summaries of Infectious Diseases

Diseases Caused by Nontuberculous Mycobacteria

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

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CLINICAL MANIFESTATIONS: Several syndromes are caused by nontuberculous mycobacteria (NTM). In children, the most common of these syndromes is cervical lymphadenitis. Less common infections include cutaneous infection, osteomyelitis, otitis media, central catheter infections, and pulmonary disease. Disseminated infections almost always are associated with impaired cell-mediated immunity, as found in congenital immune defects or human immunodeficiency virus (HIV) infection. Manifestations of disseminated NTM infections depend on the species and route of infection but include fever, night sweats, weight loss, abdominal pain, fatigue, diarrhea, and anemia. Nontuberculous mycobacteria, especially M avium complex (MAC [including Mycobacterium avium and Mycobacterium intracellulare]) and M abscessus, can be recovered from 10% to 20% of adolescents and young adults with cystic fibrosis and may be associated with fever and declining clinical status despite aggressive antipseudomonal therapy.

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ETIOLOGY: Of the many species of NTM that have been identified, only a small number account for most human infections. The species most commonly encountered in infected children are MAC, Mycobacterium fortuitum, Mycobacterium kansasii, and Mycobacterium marinum (see Table 3.73, p 662). Several new species that can be detected by nucleic acid amplification but cannot be grown by routine culture methods have been identified in lymph nodes of children with cervical adenitis. Nontuberculous mycobacteria disease in patients with HIV infection usually is caused by MAC. Mycobacterium fortuitum, Mycobacterium chelonae, and M abscessus commonly are referred to as "rapidly growing" mycobacteria, because sufficient growth and identification can be achieved in the laboratory within 3 to 7 days, whereas other NTM and Mycobacterium tuberculosis often require weeks before sufficient growth occurs. Rapidly growing . . . [Go to Full Text]

Related text in Red Book:

Summary of Major Changes in the 2003 Red Book

Red Book 2003: xxv. [Extract] [Full Version]  

Tuberculosis

Red Book 2003: 642-660. [Extract] [Full Version]  

Fluoroquinolones

Red Book 2003: 693-694. [Extract] [Full Version]  

This topic has been referenced by these articles:

• Dupuis-Girod, S., Corradini, N., Hadj-Rabia, S., Fournet, J.-C., Faivre, L., Le Deist, F., Durand, P., Doffinger, R., Smahi, A., Israel, A., Courtois, G., Brousse, N., Blanche, S., Munnich, A., Fischer, A., Casanova, J.-L., Bodemer, C. (2002). Osteopetrosis, Lymphedema, Anhidrotic Ectodermal Dysplasia, and Immunodeficiency in a Boy and Incontinentia Pigmenti in His Mother. Pediatrics 109: e97-97 [Abstract] [Full Version]  
• Nolt, D., Michaels, M. G., Wald, E. R. (2003). Intrathoracic Disease From Nontuberculous Mycobacteria in Children: Two Cases and a Review of the Literature. Pediatrics 112: e434-434 [Abstract] [Full Version]  

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