Challenges of diagnosing and treating non-tuberculous mycobacterial pulmonary disease [NTM-PD]: A case series.
Challenges of diagnosing and treating non-tuberculous mycobacterial pulmonary disease [NTM-PD]: A case series.
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DOI：
10.1016/j.jctube.2021.100271
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发表时间：
2021-12
影响因子：
2
通讯作者：
Patil E
中科院分区：
文献类型：
--
作者：
Chindam A;Vengaldas S;Srigiri VR;Syed U;Kilaru H;Chenimilla NP;Kilaru SC;Patil E
NTM-PD 临床放射学可能模拟肺结核，从而带来诊断挑战。 Xpert MTB/RIF 检测呈阴性的 AFB 涂片阳性为怀疑 NTM 提供了线索。建议在国家结核病规划中提供 NTM 的培养和形态。非结核分枝杆菌肺病 (NTM-PD) 的临床和放射学表现可能与肺结核 (PTB) 相似，给治疗医生带来诊断困境和挑战，特别是在结核病高发国家。尽管最近出现的数据表明人际传播，但非结核分枝杆菌 (NTM) 感染通常是从环境来源获得的。 NTM 不仅可以在免疫功能低下的人群中产生疾病，而且可以在健康个体中产生疾病，导致显着的发病率和死亡率。与 PTB 不同，NTM-PD 在资源有限的临床环境和结核病高流行国家通常难以确认和鉴定，因为特定培养设施不可用、可及性差且负担能力差。除了诊断挑战之外，导致不依从治疗的药物不良反应是另一个令人烦恼的问题。我们在此介绍四名 NTM-PD 患者的病例描述，经培养分离证实，其中一名是快速生长者，另外三名是缓慢生长者。所有四名患者均接受了现有的基于指南的治疗方案并进行了随访。
NTM-PD clinico-radiologically may simulate Pulmonary TB posing diagnostic challenges. Smear positive AFB with Xpert MTB/RIF assay negativity provides clue for suspecting NTM. Provision for Culture and speciation of NTM in National TB Programs recommended. Non-tuberculous mycobacterial pulmonary disease (NTM-PD) may simulate Pulmonary Tuberculosis (PTB) in its clinical and radiological expression posing a diagnostic dilemma and challenge to the treating physician, especially in high TB prevalent countries. Though recent emerging data indicates inter-human transmission, infection with non-tuberculous mycobacteria (NTM) is commonly acquired from the environmental sources. NTM can produce disease not only in immunocompromised populations but also in healthy individuals leading to significant morbidity and mortality. Unlike PTB, NTM-PD is usually difficult to confirm and speciate in resource limited clinical settings and high TB endemic countries due to non-availability, poor accessibility and affordability to a specific culture facility. Apart from diagnostic challenges, adverse drug effects with treatment leading to non-adherence are another vexing problem. We present here case descriptions of four patients of NTM-PD, confirmed by culture isolates, one was a rapid grower and the other three were slow growers. All four patients were treated with available guideline-based treatment protocols and followed up.
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发表时间：
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影响因子：
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