Yadav Prakrati, Meena Durga Shankar, Kumar Deepak, John Nikhil, Kaur Navneet, Kombade Sarika, Bohra Gopal Krishana, Tiwari Sarvesh, Nag Vijaylaxmi
MD, Department of Internal Medicine (Infectious Diseases Division), All India Institute of Medical Sciences, Jodhpur, 342005, India.
MD, Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, 342005, India.
Germs. 2024 Jun 30;14(2):197-203. doi: 10.18683/germs.2024.1431. eCollection 2024 Jun.
Non-tuberculous mycobacterial (NTM) disease is an underdiagnosed condition that usually manifests as pulmonary infection. Extrapulmonary manifestations are rare and can be easily overlooked or misdiagnosed as tuberculosis or malignancy.
Herein, we present four cases of extrapulmonary NTM disease in immunocompetent patients. Patient 1 had bone marrow suppression secondary to NTM infection. Patient 2 was diagnosed with meningitis, brain abscess and arachnoiditis. Patient 3 had pleural effusion, and fluid cytology revealed . Patient 4 was a 30-year-old male with cervical lymphadenopathy due to NTM. Two patients (case 2 and case 4) were initially diagnosed with tuberculosis but showed no response to anti-tubercular drugs. One patient (case 3) died within seven days of initiation of treatment. The rest of the patients (cases 1 and 2) showed clinical improvement with antimicrobial therapy for NTM species. Case 4 responded well to surgical excision without the need for antibiotics.
Clinicians should be vigilant about the possibility of NTM disease. Early diagnosis is vital to prevent poor outcomes, particularly in the setting of disseminated infections.
非结核分枝杆菌（NTM）病是一种诊断不足的疾病，通常表现为肺部感染。肺外表现罕见，容易被忽视或误诊为结核病或恶性肿瘤。
在此，我们报告4例免疫功能正常患者的肺外NTM病病例。病例1因NTM感染继发骨髓抑制。病例2被诊断为脑膜炎、脑脓肿和蛛网膜炎。病例3有胸腔积液，液体细胞学检查显示……病例4是一名30岁男性，因NTM导致颈部淋巴结病。两名患者（病例2和病例4）最初被诊断为结核病，但对抗结核药物无反应。一名患者（病例3）在开始治疗后7天内死亡。其余患者（病例1和病例2）接受针对NTM菌种的抗菌治疗后临床症状改善。病例4手术切除后效果良好，无需使用抗生素。
临床医生应警惕NTM病的可能性。早期诊断对于预防不良后果至关重要，尤其是在播散性感染的情况下。
