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Semin Respir Crit Care Med 2018; 39(03): 399-410
DOI: 10.1055/s-0038-1651490
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Management of Extrapulmonary Nontuberculous Mycobacterial Infections

Michael R. Holt
1   Division of Mycobacterial and Respiratory Infections, National Jewish Health, Denver, Colorado
2   Department of Medicine, University of Colorado Denver, Aurora, Colorado
,
Shannon Kasperbauer
1   Division of Mycobacterial and Respiratory Infections, National Jewish Health, Denver, Colorado
2   Department of Medicine, University of Colorado Denver, Aurora, Colorado
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Publikationsdatum:
02. August 2018 (online)

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Abstract

Extrapulmonary disease occurs in a minority of nontuberculous mycobacterial (NTM) infections. The pattern of disease tends to be multifocal in immunocompromised individuals and localized in the immunocompetent. There is increasing recognition of disseminated Mycobacterium chimaera infection, as a complication of cardiac surgery, and focal infections due to rapidly growing mycobacteria. Microbiologic diagnosis requires detection of NTM in blood or tissue samples by microscopy, culture, or molecular methods. Management of extrapulmonary NTM infection requires prolonged, targeted multiple-drug therapy and, in some cases, aggressive surgical intervention. The optimal treatment approach is often unknown. Despite combined medical and surgical therapy, outcomes may be poor. A high degree of clinical suspicion and early diagnosis are required to maximize chances of a positive outcome.

Keywords

nontuberculous mycobacteria - extrapulmonary - treatment - rapidly growing - Mycobacterium avium complex - Mycobacterium marinum - Mycobacterium ulcerans - disseminated