Non-Tuberculous Mycobacterial Pulmonary Disease identified during community-based screening for Mycobacterium Tuberculosis: a case report.
There is a rising prevalence of Non-Tuberculous Mycobacterial (NTM) disease in sub-Saharan Africa identified on culture specimens. However, distinguishing mycobacterial colonisations from infection from identified NTMs on culture in the sub-Saharan Africa setting remains to be established. A 49-year-old man presented with the cardinal symptoms of tuberculosis (TB) in a community TB prevalence survey in Blantyre, Malawi. Mycobacteriology was atypical, prompting a line probe assay which revealed Mycobacterium avium complex (MAC) species. The epidemiology of Mycobacterium tuberculosis complex (MTBC) is better known than that of NTM. Up-scaling culture and speciation may be a solution to this gap in knowledge of the burden of disease of NTM. Like most resource-poor settings, TB culture is not routinely done in the diagnosis and management of TB in Malawi. Furthermore, the treatment of NTM is not analogous to that of MTBC. The multi-drug regimens used for NTM disease treatment includes a newer macrolide (azithromycin, clarithromycin), ethambutol, and rifamycin, and require prolonged durations of therapy aimed at facilitating clearance of the mycobacteria and minimizing the emergence of drug resistance. Clinicians must thus be aware of this rising burden of NTM disease and consider other diagnostic options to better investigate this disease in patients.
['Twabi|Hussein H|HH|', 'Mukoka-Thindwa|Madalo|M|', 'Shani|Doris|D|', 'Nliwasa|Marriott|M|', 'Corbett|Elizabeth L|EL|']
D023241:Antiretroviral Therapy, Highly Active D000995:Antitubercular Agents D015658:HIV Infections D006801:Humans D008297:Male D008875:Middle Aged D009165:Mycobacterium Infections, Nontuberculous D009170:Nontuberculous Mycobacteria D016896:Treatment Outcome
screening Mycobacterium avium complex Non-Tuberculous mycobacteria