Department of Bacteriology, Indian Council of Medical Research (ICMR), National Institute for Research in Tuberculosis (NIRT), Chennai, India.
Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA.
Int J Tuberc Lung Dis. 2021 May 1;25(5):340-349. doi: 10.5588/ijtld.21.0002.
Diseases due to pathogenic mycobacteria cause significant health and economic impact on humans worldwide. Although mycobacterial diseases primarily affect the lungs, the involvement of extrapulmonary organs has also gained ground, particularly among individuals with co-existing medical conditions. Besides complex organisms, non-tuberculous mycobacteria (NTM) are also known to cause pulmonary and extrapulmonary diseases. Primary and disseminated extrapulmonary mycobacterial infections affect the brain, eye, mouth, tongue, lymph nodes of the neck, spine, bones, muscles, skin, pleura, pericardium, gastro-intestinal, peritoneum and genito-urinary system. The clinical presentation of extrapulmonary mycobacterial diseases, including systemic symptoms, of -infected cases and NTM-infected cases is similar. Moreover, extrapulmonary mycobacterial diseases are complicated by the involvement of diverse bacterial species as aetiological agents. Culture and molecular techniques are used to differentiate NTM from and to classify sub-species of the pathogens. As sub-speciation and drug susceptibility profiling are critical factors in treating extrapulmonary NTM diseases, there are often significant delays in initiating treatment and customising the therapeutic regimen. Here, we summarise the clinical symptoms of NTM diseases in various extrapulmonary organs, and discuss the recent trends in diagnosing and treating these diseases. We also highlight the complications associated with the management of extrapulmonary NTM disease.
致病分枝杆菌引起的疾病对全世界人类的健康和经济造成重大影响。虽然分枝杆菌病主要影响肺部，但肺外器官的受累也越来越多，特别是在存在并存医疗条件的个体中。除了复杂的生物体外，非结核分枝杆菌（NTM）也已知可引起肺部和肺外疾病。原发性和播散性肺外分枝杆菌感染影响大脑、眼睛、口腔、舌头、颈部淋巴结、脊柱、骨骼、肌肉、皮肤、胸膜、心包、胃肠道、腹膜和泌尿生殖系统。肺外分枝杆菌病的临床表现，包括感染病例和 NTM 感染病例的全身症状，相似。此外，肺外分枝杆菌病的复杂性在于涉及多种细菌物种作为病因。培养和分子技术用于区分 NTM 和分枝杆菌，并对病原体进行亚种分类。由于亚种分类和药物敏感性分析是治疗肺外 NTM 疾病的关键因素，因此在开始治疗和定制治疗方案方面常常存在显著延迟。在这里，我们总结了各种肺外器官中 NTM 疾病的临床症状，并讨论了诊断和治疗这些疾病的最新趋势。我们还强调了肺外 NTM 疾病管理相关的并发症。
