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Free Content Clinical features of non-tuberculous mycobacterial disease: comparisons between smear-positive and smear-negative cases, and between Mycobacterium avium and Mycobacterium intracellulare

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Abstract:

OBJECTIVE: To evaluate the differences in clinical symptoms and radiological findings between smear-positive non-tuberculous mycobacteria (NTM) and smear-negative, culture-positive NTM. Also, to evaluate the differences in clinical symptoms and radiological findings between Mycobacterium avium and M. intracellulare.

DESIGN: A retrospective study was performed of 200 cases with positive pulmonary cultures for NTM between January 1989 and December 1996. It was determined whether or not pulmonary disease was caused by NTM using the 1990 criteria recommended by the American Thoracic Society. Clinical symptoms and radiological findings were compared between groups.

RESULTS: Fever and hemoptysis were more frequently observed in smear-positive patients (26/50, 52%, and 24/50, 48%, respectively) than in smear-negative, culture-positive patients (8/38, 21.1%, P < 0.005, 8/38, 21.1%, P < 0.01, respectively). In addition, cavity formation was more frequently observed in chest computed tomography scans of smear-positive patients (19/36, 52.8%) than in smear-negative patients (6/31, 19.4%, P < 0.005). Finally, cavity formation tended to be more frequently observed with M. avium than with M. intracellulare.

CONCLUSION: The present study demonstrates differences in clinical symptoms and radiological findings between smear-positive and smear-negative NTM cases, as well as between M. avium and M. intracellulare.

Keywords: chest CT findings; clinical symptoms; non-tuberculous mycobacteria; smear-negative; smear-positive

Document Type: Regular Paper

Affiliations: 1: Takamatsu Central Hospital, Kagawa, Japan 2: Kagawa Medical University, Kagawa, Japan 3: Mitoyo General Hospital, Kagawa, Japan 4: Kagawa Prefectural Central Hospital, Kagawa, Japan 5: West Kagawa Central Hospital, Kagawa, Japan

Publication date: July 1, 1998

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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