Pulmonary Disease From Nontuberculous Mycobacteria in Patients With Human Immunodeficiency Virus: M gordonae
Mycobacterium gordonae (formerly M aquae) is often isolated from water sources and is usually considered nonpathogenic when isolated from patient specimens. Rare cases of well-documented infection, typically in patients with immunosuppression or malignancy, have been reported. Disseminated M gordonae infection involving the lung and bone marrow has been reported in a patient with AIDS.
A review of the medical records of all patients from Boston City Hospital who had positive sputum cultures for M gordonae between 1987 and 198931 revealed that 5 of 15 patients identified had HIV infection. Three of these five were believed to have evidence of infection with M gordonae. One patient had concurrent M tuberculosis infection. Radiographic abnormalities in patients with M gordonae infection consisted primarily of lower lobe interstitial infiltrates. Canadian neighborhood pharmacy fully All three had clinical and radiographic improvement after treatment with antituberculous medications. Two of the three had positive sputum acid-fast stains.
A newly identified, slow growing, nonphotochro-mogenic mycobacterial species has recently been described This species, which has been named M celatum, was identified from 24 patient isolates. Seven of these patients were known to be HIV infected. Most isolates were from pulmonary specimens, but one patient of unknown HIV status had a bloodstream isolate. The clinical significance of this organism has not been described, but it appears to be resistant in vitro to most antituberculous drugs.
Radiographic Features of NTM Pulmonary Disease and AIDS
Previous reports suggest that the radiographic features of NTM pulmonary disease in patients with HIV infection differ from those seen in other hosts. This may reflect the absence of destructive changes noted in the immunocompetent patient. Marinelli et al in one of the earlier reviews of NTM and AIDS, noted that of ten patients, none had cavitary disease or effusion and only one had adenopathy. Half of the patients had evidence of disseminated disease and concomitant pulmonary complications resulting in diffuse pulmonary involvement.
Category: Respiratory Symptoms
Tags: AIDS, atypical Mycobacterium infections, HIV infection, Mycobacterium avium-intracellulare infection