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Beyond Symptoms: Radiologic identification of asymptomatic Mycobacterium avium complex pulmonary infections.
Fujiwara, Keiji; Watanabe, Fumiya; Uesugi, Fumiko; Furuuchi, Koji; Ito, Masashi; Kodama, Tatsuya; Tanaka, Yoshiaki; Yoshiyama, Takashi; Mitarai, Satoshi; Kurashima, Atsuyuki; Ohta, Ken; Morimoto, Kozo.
Afiliación
  • Fujiwara K; Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan; Department of Mycobacterium Reference and Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan; Department of Basic Mycobacteriosis, Nagasaki University Gr
  • Watanabe F; Department of Pharmacometrics and Pharmacokinetics, Meiji Pharmaceutical University, Tokyo, Japan.
  • Uesugi F; Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan.
  • Furuuchi K; Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan.
  • Ito M; Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan.
  • Kodama T; Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan.
  • Tanaka Y; Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan.
  • Yoshiyama T; Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan.
  • Mitarai S; Department of Mycobacterium Reference and Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan; Department of Basic Mycobacteriosis, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
  • Kurashima A; Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan.
  • Ohta K; Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan.
  • Morimoto K; Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan; Department of Clinical Mycobacteriosis, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Division of Clinical Research, Fukujuji Hospital, Japan Anti-Tuberculosis Association
Respir Med ; 226: 107627, 2024 May.
Article en En | MEDLINE | ID: mdl-38604553
ABSTRACT

BACKGROUND:

Although international nontuberculous mycobacterial pulmonary disease (NTM-PD) guidelines highlight symptom presence at diagnosis, the clinical characteristics of asymptomatic Mycobacterium avium complex pulmonary infection (MAC-PI) patients remain understudied. We clarified the clinical characteristics and course of asymptomatic MAC-PI patients.

METHODS:

We retrospectively analyzed 200 consecutive patients with MAC-PIs and adequate available data who newly met the microbiological and radiological criteria for NTM-PD at Fukujuji Hospital from January 2018 to June 2020. We compared the clinical characteristics and course of asymptomatic patients with symptomatic patients and evaluated factors influencing treatment initiation through multivariate analysis.

RESULTS:

111 patients were symptomatic and 89 were asymptomatic at diagnosis. While the proportion was significantly lower than that in the symptomatic group (28.8 %), 15.7 % of asymptomatic group patients had cavitary lesions (P = 0.042). In the asymptomatic group, treatments were initiated in 38 (42.7 %) patients, and cavitary lesions, a positive acid-fast bacilli smear, and younger age were independent risk factors for treatment initiation. Among 22 (57.9 %) patients who experienced disease progression necessitating treatment during follow-up, 13 (34.2 %) displayed radiological progression without any worsening of symptoms. Agents used for treatment were consistent across the groups, with no significant differences in culture conversion, microbiological recurrence rates, or spontaneous culture conversion rates.

CONCLUSION:

Routine health checkups and radiological examinations can detect clinically important MAC-PIs even in the absence of symptoms. Considering that the clinical course of asymptomatic MAC-PI patients is largely similar to that of symptomatic patients, timely and appropriate management and intervention are essential for all MAC-PI patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complejo Mycobacterium avium / Infección por Mycobacterium avium-intracellulare Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Respir Med Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complejo Mycobacterium avium / Infección por Mycobacterium avium-intracellulare Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Respir Med Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido