Non-tuberculous mycobacterial lung disease and copd
Journal
ERS Monograph
Journal Volume
2015
Journal Issue
9.78185E+12
Pages
172-184
Date Issued
2015
Abstract
Case history: A 53-year-old woman with COPD has had a cough with sputum for the last 8 years and received maintenance ICS therapy. She suffered from recurrent episodes of exacerbation of airway symptoms, often requiring antibiotic therapy. Erythromycin has been given in the last 6 months. She presented with more severe cough, copious sputum and exertional dyspnoea. Chest CT revealed bronchial wall thickening and multifocal tree-in-bud lesions. All three sputum samples collected within 1 week grew Mycobacterium avium complex. Is this AECOPD, non-tuberculous mycobacterial lung disease, or both? Chapter summary: Non-tuberculous mycobacteria (NTM) are common organisms that can infect patients with chronic debilitating lung diseases. The incidence of NTM lung disease (NTM-LD) is increasing in patients with COPD. Lung structural changes due to NTM-LD may make the host more vulnerable to NTM infection. The diagnosis of NTM-LD requires the fulfilment of both clinical and microbiological criteria. However, a correct diagnosis of NTM-LD in COPD patients is usually difficult. The decision for NTM treatment should be based on the potential risk and benefit of therapy. Particular therapeutic concerns exist, especially regarding corticosteroids and macrolides. Since the presence of NTM may lead to worsening lung function and AECOPD, the outcome of patients with concomitant NTM-LD and COPD is likely to be worse. However, significant controversy exists in many areas, and further longitudinal studies are urgently needed.
SDGs
Publisher
European Respiratory Society
Type
journal article