Clinical characteristics and prognosis of nontuberculous mycobacterial lung disease with different radiographic patterns.

Abstract:

RATIONALE:The clinical characteristics and prognostic impact of radiographic patterns of patients with nontuberculous mycobacterial lung disease (NTM-LD) are rarely evaluated. DESIGN:Patients with NTM-LD from 2007 to 2009 in a single medical center in Taiwan were identified. Their radiographic patterns were reviewed and classified into cavitary, bronchiectatic, or consolidative. They were also compared to patients with cavitary pulmonary tuberculosis (TB-LD). RESULTS:Of 481 NTM-LD patients identified, 62, 134, and 56 patients were categorized into cavitary, bronchiectatic, and consolidative groups, respectively. Compared with 180 TB-LD patients, cavitary NTM-LD had male predominance and was associated with higher grades of sputum acid-fast smear (3+ or 4+), prior pulmonary TB, and poor baseline pulmonary function. NTM-LD patients with consolidative pattern were likely to have underlying comorbidity, the highest blood leukocyte count and C-reactive protein, and lowest albumin. In all NTM-LD, the consolidative pattern was independently associated with poor prognosis for 6-month survival. Patients with cavitary Mycobacterium avium complex (MAC)-LD had worse 6-month survival than those with bronchiectatic pattern. CONCLUSION:In Taiwan, NTM-LD patients with consolidative pattern have the worst prognosis while patients with cavitary pattern have worse survival than those with bronchiectasis in MAC-LD. Because varying radiographic patterns represent different prognoses, understanding the characteristics of NTM-LD patients with different radiographic patterns complements clinical practice.

journal_name

Lung

journal_title

Lung

authors

Shu CC,Lee CH,Hsu CL,Wang JT,Wang JY,Yu CJ,Lee LN,TAMI Group.

doi

10.1007/s00408-011-9321-4

subject

Has Abstract

pub_date

2011-12-01 00:00:00

pages

467-74

issue

6

eissn

0341-2040

issn

1432-1750

journal_volume

189

pub_type

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