Clinical characteristics and prognosis of nontuberculous mycobacterial lung disease with different radiographic patterns
Journal
Lung
Journal Volume
189
Journal Issue
6
Pages
467-474
Date Issued
2011
Author(s)
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. ? 2011 Springer Science+Business Media, LLC.
SDGs
Other Subjects
albumin; antimycobacterial agent; C reactive protein; adult; article; bronchiectatic nontuberculous mycobacterial lung disease; cavitary nontuberculous mycobacterial lung disease; clinical feature; comorbidity; consolidative nontuberculous mycobacterial lung disease; disease classification; female; human; leukocyte count; lung disease; lung function; lung tuberculosis; major clinical study; male; medical record review; Mycobacterium avium complex lung disease; Mycobacterium intracellulare avium; patient identification; priority journal; prognosis; radiodiagnosis; sputum smear; Taiwan; Adult; Aged; Aged, 80 and over; C-Reactive Protein; Female; Humans; Kaplan-Meier Estimate; Lung; Lung Diseases; Male; Middle Aged; Mycobacterium avium Complex; Mycobacterium Infections, Nontuberculous; Prognosis; Retrospective Studies; Serum Albumin; Tuberculosis, Pulmonary
Type
journal article