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Clinical and radiological features of pulmonary disease caused by rapidly growing mycobacteria in cancer patients

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Abstract

The role of rapidly growing mycobacteria in the pathogenesis of pulmonary disease is being increasingly recognized; however, the clinical significance of these mycobacteria in patients with underlying malignancy has not been well studied. Over a 6-year period, 37 cancer patients with rapidly growing mycobacteria isolated from respiratory specimens were identified at our center.Mycobacterium chelonae group was isolated in 24 cases andMycobacterium fortuitum in 13 cases. Of the 24 cases with cultures yieldingMycobacterium chelonae group, eight met the study criteria for infection and were determined to be clinically significant, whereas only one of theMycobacterium fortuitum isolates was determined to represent infection. An average of two antimicrobial agents were used for treatment, most commonly clarithromycin, ciprofloxacin, and trimethoprim/sulfamethoxazole. Although the isolation of rapidly growing mycobacteria represents colonization in most cases, these bacteria, especially theMycobacterium chelonae group, may cause pulmonary disease in cancer patients. The clinical and radiological findings are usually non-specific in this population, and patients with respiratory cultures yielding rapidly growing mycobacteria should be assessed carefully to distinguish infection from colonization. Effective therapy can be provided with oral regimens that include at least two antibiotics to which the organism is susceptible.

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Authors and Affiliations

  1. Department of Medical Specialties, Section of Infectious Diseases, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Box 47, 77030, Houston, Texas, USA

    K. Jacobson, R. Garcia, H. Libshitz, E. Whimbey, K. Rolston, D. Abi-Said & I. Raad

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  1. K. Jacobson
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  2. R. Garcia
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  3. H. Libshitz
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  4. E. Whimbey
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  5. K. Rolston
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  6. D. Abi-Said
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  7. I. Raad
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Jacobson, K., Garcia, R., Libshitz, H. et al. Clinical and radiological features of pulmonary disease caused by rapidly growing mycobacteria in cancer patients. Eur. J. Clin. Microbiol. Infect. Dis. 17, 615–621 (1998). https://doi.org/10.1007/BF01708343

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