Pulmonary nontuberculous mycobacterial infection: radiologic manifestations.

Published

Journal Article (Review)

The nontuberculous mycobacteria (NTMB) are a group of bacteria that can infect the cervical lymph nodes, skin, soft tissues, and lung. Pulmonary NTMB disease is increasing in prevalence and is most commonly caused by Mycobacterium avium-intracellulare or M kansasii. Occasionally, M xenopi, M fortuitum, or M chelonae also causes pulmonary disease. Diagnosis of pulmonary NTMB infection is often difficult because isolation of the organism from sputum or bronchoalveolar lavage fluid can represent airway colonization. The radiologic manifestations of pulmonary NTMB infection are protean and include consolidation, cavitation, fibrosis, nodules, bronchiectasis, and adenopathy. Pulmonary NTMB infection has five distinct clinicoradiologic manifestations: (a) classic infection, (b) nonclassic infection, (c) nodules in asymptomatic patients, (d) infection in patients with achalasia, and (e) infection in immunocompromised patients. Although classic NTMB infection may be indistinguishable from active tuberculosis, it is usually more indolent. The radiologic features of nonclassic NTMB infection are characteristic: bronchiectasis and centrilobular nodules isolated to or most severe in the lingula and middle lobe. In patients with acquired immunodeficiency syndrome, mediastinal or hilar adenopathy is the most common radiographic finding. Knowledge of the full spectrum of clinical and radiologic features of pulmonary NTMB infection is important to facilitate diagnosis and treatment.

Full Text

Duke Authors

Cited Authors

  • Erasmus, JJ; McAdams, HP; Farrell, MA; Patz, EF

Published Date

  • November 1999

Published In

Volume / Issue

  • 19 / 6

Start / End Page

  • 1487 - 1505

PubMed ID

  • 10555671

Pubmed Central ID

  • 10555671

Electronic International Standard Serial Number (EISSN)

  • 1527-1323

International Standard Serial Number (ISSN)

  • 0271-5333

Digital Object Identifier (DOI)

  • 10.1148/radiographics.19.6.g99no101487

Language

  • eng