Nontuberculous Mycobacteria Lung Disease

Introduction:

Nontuberculous mycobacteria infection spreads to humans from soil and water. Though it does not result in tuberculosis, it is related to the bacteria causing mycobacterium tuberculosis. The bacterial infection is airborne but does not spread to everyone. Individuals with healthy immune systems are not affected. Nontuberculous mycobacteria do not cause contagious spread. The most common bacteria that results in nontuberculous mycobacteria is Mycobacterium avium. It usually spreads through blood and affects other organs like lungs, bones, lymph nodes, and skin.

What Are the Causes of Nontuberculous Mycobacteria Lung Disease?

The nontuberculous mycobacteria infection either remains localized or spreads to different parts of the body. The various causes of nontuberculous mycobacteria lung disease are as follows;

• The nontuberculous mycobacteria infection spreads through open wounds present due to the incision made during the surgery.

• The nontuberculous mycobacteria present in domestic water enter the human body while drinking the same.

• The nontuberculous mycobacteria infection affects the skin while bathing or showering with contaminated water.

• The nontuberculous mycobacteria enter the bloodstream during surgery from the catheter or other surgical instruments.

What Are the Symptoms of Nontuberculous Mycobacteria Lung Disease?

Mild infection does not induce any symptoms and recedes after a few days. But severe infection causes the following symptoms:

• Cough - The nontuberculous mycobacteria enter the air passages and cause an inflammatory reaction in the bronchial tubes. This produces a cough. It usually does not subside and lasts for a few weeks. The condition in which the blood is produced while coughing is called hemoptysis.

• Fatigue - Since the nontuberculous mycobacteria affect the immune system, the individual becomes exhausted and weak.

• Fever - The nontuberculous mycobacteria enters the bloodstream and increases the body temperature. It eventually leads to fever.

• Night Sweats - Some patients with nontuberculous mycobacteria lung disease have frequent night sweats during sleep.

• Breathing Difficulty - The bacterial infection affects a major part of the lungs and causes shortness of breath.

• Skin Disorders - The infection causes dryness and rashes on the skin. Severe bacterial infection results in heat boil and sore skin.

• Weight Loss - The patients with nontuberculous mycobacteria lung disease have severe dehydration and lose weight.

• Lymph Node Enlargement - The dissemination of bacterial infection to the lymph nodes causes enlargement and leads to a condition called lymphadenitis.

How Is Nontuberculous Mycobacteria Lung Disease Diagnosed?

The diagnostic measures of nontuberculous mycobacteria lung disease are similar to other lung infections. They are as follows;

• Chest X-Rays - The spread of nontuberculous mycobacteria into the air passages and lungs is identified using the radiographic image. It is also helpful to know the extent of lung infection. It is usually suggested by the medical professional if the patient has symptoms related to respiratory infections.

• Culture Test - The samples of sputum and blood are collected from the patients who are suspected of nontuberculous mycobacteria lung disease. For accurate results, several mucus samples are collected continuously in the early mornings. The lab technician then observes the proliferation of bacteria using an electron microscope. It is also investigated using a culture medium.

• Bronchoscopy - The inflammation produced by the nontuberculous mycobacteria in the air passages is observed using a bronchoscope. It is a non-invasive method and allows the medical professional to inspect structures like the throat, bronchi, and lungs. It is used along with computed tomography because the scan images guide the surgeon to insert the tube.

• Biopsy - If the nontuberculous mycobacteria affect the lung lobes, then the lung tissue is surgically excised to make a confirmatory diagnosis. Then the mycobacteria infection is detected using a microscope and culture test. Tissue is also collected from the other major organs suspected of nontuberculous mycobacteria infection spread.

What Are the Treatment Methods for Nontuberculous Mycobacteria Lung Diseases?

The progress of nontuberculous mycobacteria lung infection is very slow. It can be controlled using the following medications;

• Like tuberculosis infection, the nontuberculous mycobacteria infection is treated with Rifampin and Ethambutol.

• Azithromycin is used as an antibiotic to treat respiratory infections.

• These medications are used as combination therapy for effective results. One or two drugs are combined to avoid drug resistance by the nontuberculous mycobacteria. These medications are usually prescribed for eight to twelve months.

• The lung disease is managed with the help of inhalation suspension. The commonly used antibiotic is Amikacin. Streptomycin sulfate can also be used. But some patients are allergic to the sulfate group, which can result in potential side effects.

• Sputum culture is useful for the medical professional to decide on the drug type because certain types of mycobacterium are resistant to certain drugs.

• The medication should be stopped only on the advice of a healthcare professional. So the medical professional will monitor the symptoms and collect sputum samples every month. If the results are continuously negative for a year, then the antibiotics can be stopped.

• Topical gels are used to treat skin lesions due to nontuberculous mycobacterial infections. The extensive skin sores and boils are cleaned with antiseptic creams, and a dressing is given to avoid contamination.

Conclusion:

Nontuberculous mycobacteria lung disease is a very rare condition. The medications that are used to treat nontuberculous mycobacteria lung disease induces nausea and vomiting. In such situations, consult the medical professional and request a change in the type of medication. The risk of infection increases due to the excess widening of air passages. It occurs due to frequent exposure to nontuberculous mycobacteria. The patient should avoid taking baths in hot tubs present in a closed environment. The bacteria enter through fine mist produced by the water sprayer. It particularly affects the individual with a weak immune system. Avoid walking barefoot in agricultural lands and soils. The prognosis of nontuberculous mycobacteria lung disease depends on the site of infection. The recovery time takes around one year.