DÄ internationalArchive9/2010Disseminated Non-tuberculous Mycobacteriosis

Correspondence

Disseminated Non-tuberculous Mycobacteriosis

Dtsch Arztebl Int 2010; 107(9): 149. DOI: 10.3238/arztebl.2010.0149a

Kropp, R; Schulz, V

LNSLNS The impressive case report of a pathology that manifested primarily as osteolyses in different skeletal areas cannot be assigned to a diagnosis of tuberculosis of the bone.

Tuberculosis is the exclusive name for all pathologies caused by Mycobakterium tuberculosis complex. Mycobacterium avium intracellulare complex, as found in the culture of the patient whose case was reported, is one of the non-tuberculous mycobacteria known as MOTT (“mycobacteria other than tuberculosis”) (13). The diagnosis of the case patient should therefore have been: disseminated non-tuberculous mycobacteriosis, caused by Mycobacterium avium intracellulare complex—a pathology that is often observed in association with HIV infection and in the course of neoplastic hematological disorders, such as in the case report.

In general, the distinction between TB and MOTT is of far reaching importance. The route of infection, pathogenicity, responsiveness to antimycobacterial medication, and often the clinical presentation are different—factors that influence diagnosis, treatment, and prognosis.
DOI: 10.3238/arztebl.2010.0149a

Dr. med. Robert Kropp
Prof. Dr. med. Volker Schulz
Deutsches Tuberkulose-Archiv
Liegnitzer Str. 5
36100 Petersberg, Germany
dr.robert.kropp@gmx.de
1.
Konietzko N, Loddenkemper R: Tuberkulose. Stuttgart: Georg Thieme Verlag 1999.
2.
Henry MT, Inamdar L, O‘Riordain D, Schweiger M, Watson JP: Nontuberculous mycobacteria in non-HIV patients: epidemiology, treatment and response. Eur Respir J 2004; 23: 741–6. DOI: 10.1183/09031936.04.00114004 MEDLINE
3.
Griffith DE, et al.: An Official ATS/IDSA Statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med 2007; 175: 367–416. DOI: 10.1164/rccm.200604-571ST MEDLINE
4.
Herzog A: Case report: dangerous errors in the diagnosis and treatment of bony tuberculosis [Gefährliche Fehler in Diagnostik und Therapie einer Knochentuberkulose]. Dtsch Arztebl Int 2009; 106 (36): 573–7. VOLLTEXT
1. Konietzko N, Loddenkemper R: Tuberkulose. Stuttgart: Georg Thieme Verlag 1999.
2. Henry MT, Inamdar L, O‘Riordain D, Schweiger M, Watson JP: Nontuberculous mycobacteria in non-HIV patients: epidemiology, treatment and response. Eur Respir J 2004; 23: 741–6. DOI: 10.1183/09031936.04.00114004 MEDLINE
3. Griffith DE, et al.: An Official ATS/IDSA Statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med 2007; 175: 367–416. DOI: 10.1164/rccm.200604-571ST MEDLINE
4. Herzog A: Case report: dangerous errors in the diagnosis and treatment of bony tuberculosis [Gefährliche Fehler in Diagnostik und Therapie einer Knochentuberkulose]. Dtsch Arztebl Int 2009; 106 (36): 573–7. VOLLTEXT