Provincial Center for Training, Education, and Learning (PCTEL), Nova Scotia Health Authority, Mental Health and Addictions, Community Wellness Center, Office 3, 16 Denith Road, Halifax, NS, B3R2H9, Canada.
Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Center, Halifax, NS, B3H2E2, Canada.
Eat Weight Disord. 2021 Jun;26(5):1691-1695. doi: 10.1007/s40519-020-00967-8. Epub 2020 Jul 24.
Cases of nontuberculous Mycobacterium (NTM) are on the rise across North America. This is the first clinical description of a 31-year old male patient in North America with Mycobacterium kansasii who met DSM-5 diagnostic criteria for anorexia nervosa (AN) and obsessive compulsive disorder (OCD), and who was engaged in specialized outpatient treatment of an eating disorder. The patient did not disclose at intake assessment that he was experiencing symptoms of a persistent cough, blood in his sputum, or that he was simultaneously being assessed outside of the eating disorders program for NTM until he had a positive smear for Mycobacterium kansasii in March 2017. The patient made progress in treatment in his weight status and some psychological symptoms despite the concurrent NTM symptoms. However, later treatment attendance was negatively impacted by the side effects of his medication regime for NTM and careful follow-up was required to monitor for potential interactions between his treatment for NTM and psychiatric medication. This case report provides an initial window into clinicians' ability to treat a patient with a concurrent eating disorder and an NTM infection and lessons learned in the process. LEVEL OF EVIDENCE: Level V: Opinions of respected authorities, based on descriptive studies, clinical experience, or reports of expert committees.
非结核分枝杆菌(NTM)病例在北美呈上升趋势。这是北美首例符合 DSM-5 厌食症(AN)和强迫症(OCD)诊断标准的 31 岁男性患者的临床描述,他患有堪萨斯分枝杆菌,同时正在接受饮食失调的专门门诊治疗。该患者在摄入评估时并未透露自己持续咳嗽、咳痰带血的症状,也没有透露他同时正在饮食失调计划之外接受 NTM 评估,直到 2017 年 3 月他的痰涂片检测出堪萨斯分枝杆菌阳性。尽管同时存在 NTM 症状,但该患者在体重状况和一些心理症状方面的治疗取得了进展。然而,后来由于 NTM 治疗药物的副作用,他的治疗出勤率受到了负面影响,需要密切随访以监测他的 NTM 治疗和精神科药物治疗之间的潜在相互作用。本病例报告初步揭示了临床医生同时治疗患有饮食失调和 NTM 感染的患者的能力,以及在此过程中吸取的经验教训。证据水平:V 级:基于描述性研究、临床经验或专家委员会报告的权威意见。