Recent experience in the epidemiology of disease caused by atypical mycobacteria.
ABSTRACT To obtain information on the epidemiology of mycobacteriosis, water and air samples collected along the East Coast of the United States were examined for mycobacteria. Mycobacterium avium-intracellulare-scrofulaceum (MAIS) were isolated from 25% of the water, samples, mostly those from South Carolina, Georgia, and the Gulf states. Mycobacterium kansasii and Mycobacterium marinum were not found, probably because of the detrimental effects of the NaOH used to decontaminate the samples. MAIS strains were found more often in estuaries than in fresh or ocean waters. The frequency of Mycobacterium intracellulare was relatively uniform along the entire coast, while Mycobacterium scrofulaceum predominated in the South. Only M. intracellulare was found in aerosol specimens, although both M. intracellulare and M. scrofulaceum were found in waters collected at the same sites.
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ABSTRACT: Intense immunosuppressive therapy is used frequently for treatment of systemic vasculitides, collagenoses, rapidly progressive glomerulonephritis, and after organ transplantation. Numerous serious treatment-related side effects include localized or disseminated opportunistic infections, and require careful monitoring of immunosuppressed patients. Gastrointestinal infections with Mycobacterium avium complex (MAC) or other nontuberculous mycobacteria have been previously identified in HIV seropositive patients only. We now report the first case of an HIV seronegative patient who received immunosuppressive therapy for rapidly progressive glomerulonephritis. The patient presented with severe lower gastrointestinal bleeding and was diagnosed to have ulcerative colitis due to infection with MAC. The patient recovered promptly after administration of antimycobacterial therapy. MAC infection should be included in the differential diagnosis of gastrointestinal bleeding in all immunodeficient patients. The significance of repeated colonoscopy to obtain multiple biopsy specimens with histological examination for foam cells and specific staining for acid-fast organisms is emphasized.The American Journal of Gastroenterology 02/1999; 94(1):232-5. · 9.21 Impact Factor
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ABSTRACT: We report the case of a 36-year-old man who had acquired immune deficiency syndrome and developed suppurative mediastinitis extending over the left lung and anterior thoracic wall around the sternum, pericardial effusions, splenomegaly, and mesenteric and periaortic lymphadenomegaly due to Mycobacterium avium (genotype I). The organism was isolated from an axillary lymph node and the bone marrow. Mediastinitis associated with disseminated M. avium complex infection is uncommon and, to the best of our knowledge, this manifestation has not reported before.Revista da Sociedade Brasileira de Medicina Tropical 06/2012; 45(3):407-9. · 0.93 Impact Factor
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ABSTRACT: The majority of investigations of the epidemiology of nontuberculous mycobacteria (NTM) have focused on highly developed nations with a low prevalence of tuberculosis. In contrast, the Para state of north Brazil represents an area of high tuberculosis prevalence and increasing NTM incidence. Toward the goal of understanding the dynamics of infection by all Mycobacterium species, we report patient characteristics and the identification of NTM strains isolated from sputum samples from patients that were residents of Para, a state in the Amazon region, Northern of Brazil, over the period January 2010 through December 2011 (2 years). The 29 NTM patients comprised 13.5% of positive mycobacterial cultures over the 2-year period. A major risk factor for NTM pulmonary disease was previous tuberculosis (76%). Further, the average age of NTM patients (52 years) was significantly higher than that of tuberculosis patients (39 years) and more were female (72.4% vs. 37.4%). Unlike other Brazilian states, NTM pulmonary patients in Para were infected with a different spectrum of mycobacteria; primarily the rapidly growing Mycobacterium massiliense and Mycobacterium simiae complex.PLoS Neglected Tropical Diseases 07/2013; 7(7):e2340. · 4.57 Impact Factor