Kuthiah Navin, Chaozer Er
WHC Office, Level 5, Tower E, Yishun Community Hospital, 2 Yishun Central 2, 768024, Singapore,
Internal Medicine, Woodlands Health Campus, Yishun, Singapore.
J R Coll Physicians Edinb. 2019 Sep;49(3):217-221. doi: 10.4997/JRCPE.2019.309.
The incidence and prevalence of nontuberculous mycobacteria (NTM) infection is on the rise with many cases still going unreported. Given the vague and nonspecific clinical features of NTM infections, it is often missed or mistaken for Mycobacterium tuberculosis. The presumption that NTM infections are benign and do not contribute to morbidity no longer holds true. NTM infections need to be considered in patients with disseminated multisystem disease and in those not responding to standard M. tuberculosis treatment. As NTM infection is associated with granuloma formation, it can result in hypercalcaemia. Interestingly, there is evidence that there may be other mechanisms in play contributing to hypercalcaemia besides the increased calcitriol levels.
非结核分枝杆菌(NTM)感染的发病率和患病率正在上升,许多病例仍未报告。鉴于NTM感染的临床特征模糊且不具特异性,其常常被漏诊或误诊为结核分枝杆菌。认为NTM感染是良性的且不会导致发病的假设已不再成立。对于患有播散性多系统疾病的患者以及对标准抗结核治疗无反应的患者,需要考虑NTM感染。由于NTM感染与肉芽肿形成有关,它可导致高钙血症。有趣的是,有证据表明,除了骨化三醇水平升高外,可能还有其他机制导致高钙血症。