Mycobacterium avium Complex Pulmonary Disease Presenting as an Isolated Lingular or Middle Lobe Pattern

Reich, Jerome M.; Johnson, Richard E.

doi:10.1378/chest.101.6.1605

Cited by 343 publications

(187 citation statements)

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“…The disease resembles typical tuberculosis clinically and radiographically, with cough, weight loss, upper lobe infiltrates, and cavities [5,6]. The second form presents as nodular bronchiectasis in immunocompetent adults without known underlying lung disease, usually nonsmoking slender women who have some skeletal deformities [7,8]. The third form presents as hypersensitivity pneumonitis after use of hot tubs and medicinal baths [9].…”

Section: Discussionmentioning

confidence: 99%

Rare case of Mycobacterium nebraskense presenting as asymptomatic cavitary lung lesion

Abdulfattah

Lixon

Kandel

et al. 2018

Journal of Community Hospital Internal Medicine Perspectives

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Introduction: Mycobacterium Nebraskense is a rare nontuberculous mycobacterial infection. The first isolate of the species was from human sputum at University of Nebraska Medical Center. There are only a few cases have been reported and the exact behavior of the disease is not clearly described. Here, we present a case from New York City incidentally found to have a cavitary lung lesion due to M. nebraskense. Case report: An 82-year-old female with a history of diabetes mellitus, hypertension, and dementia presented with constipation and urinary retention for 1 day. She had no fever, cough, shortness of breath, nausea, vomiting, appetite change, or weight loss. Computed tomography (CT) scan of abdomen and pelvis revealed retained fecal material in the colon, non-obstructing left renal calculus, and bilateral small pleural effusion with right-sided lung infiltrates. Subsequent CT scan of the chest showed 4.5 cm pleural-based opacity in right lung base with a small cavity. Sputum smear for Acid-fast bacilli was positive. Mycobacterial culture reported positive growth of M. nebraskense, while polymerase chain reaction returned negative for Mycobacterium gordonae, Mycobacterium kansasii, Mycobacterium avium complex and Mycobacterium tuberculosis. With the patient asymptomatic and her constipation improved, she was discharged with plans for close follow-up as outpatient. Conclusion : M. nebraskense is a very rare nontuberculous mycobacterial infection. From only a few cases reported in the USA, the exact presentation of infection, disease progression, and treatment have not been described well. Asymptomatic cavitary lung disease caused by M. nebraskense has not been reported before.

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Section: Discussionmentioning

confidence: 99%

Rare case of Mycobacterium nebraskense presenting as asymptomatic cavitary lung lesion

Abdulfattah

Lixon

Kandel

et al. 2018

Journal of Community Hospital Internal Medicine Perspectives

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“…Most lung transplant patients with GERD lack classic symptoms [14], and although acid suppression therapy is frequently given to this patient group, non-acid reflux is present in up to 50% as documented by the finding of bile acids in lung lavage samples [13], a finding associated with BOS in one study [84]. Supporting the aetiological role of GERD in a subset of BOS patients, DAVIS et al [85] NTM infection NTM infection of the lung may produce a clinical picture of nodular bronchiectasis in nonsmokers [86], and this disease has been associated with oesophageal disorders [87][88][89]. A recent paper from Korea described 58 HIV-negative patients (86% female) with nodular bronchiectasis due to NTM who had 24-hr oesophageal pH probe evaluation [90].…”

Section: Bronchiolitis Obliterans In Lung Transplant Recipientsmentioning

confidence: 98%

Gastro-oesophageal reflux disease and non-asthma lung disease

Morehead¹

2009

European Respiratory Review

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Gastro-oesophageal reflux disease (GERD) is a common disorder in Western countries, and its relationship to airways disorders (e.g. asthma) has been well established. Lung diseases other than asthma have also been associated with GERD, but the nature and scope of this relationship has not been fully defined. Diseases that have been associated with GERD include bronchiolitis syndromes, idiopathic pulmonary fibrosis, scleroderma and nontubercular mycobacterial infection.Diagnostic evaluation centres upon proving both reflux and pulmonary aspiration, which may be accomplished in some cases by lung biopsy. However, in many cases a compatible clinical and radiographic picture coupled with proof of proximal reflux by combined oesophageal probe testing may suffice for a provisional diagnosis and allow institution of anti-reflux measures.Proton-pump inhibitors are the medications of choice for GERD; other interventions shown to reduce reflux are weight loss, elevation of the head of the bed and avoidance of recumbency after meals. However, acid suppression therapy does not address non-acid reflux that may be important in disease pathogenesis in select patients, and lifestyle modifications often fail.Laparoscopic fundoplication is the procedure of choice for medically refractory GERD with excellent short-term results with respect to respiratory symptoms associated with GERD; however, long-term studies document a significant percentage of patients requiring ongoing acid suppression therapy.

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“…The term "Lady Windermere syndrome" was first used in 1992 by Reich and Johnson to describe 6 older women who presented with right middle lobe or lingular infiltrates and evidence of infection with MAC (46). The name they assigned to the syndrome was drawn from a play by Oscar Wilde, and was chosen to reflect the authors' contention that the patients in their series had voluntary suppression of cough, a behavior they ascribed to Wilde's character.…”

Section: Clinical Syndromesmentioning

confidence: 99%

Tuberculosis and Nontuberculous Mycobacterial Infections in Older Adults

Schluger

2007

Clinics in Chest Medicine

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Mycobacterium avium Complex Pulmonary Disease Presenting as an Isolated Lingular or Middle Lobe Pattern

Cited by 343 publications

References 10 publications

Rare case of Mycobacterium nebraskense presenting as asymptomatic cavitary lung lesion

Rare case of Mycobacterium nebraskense presenting as asymptomatic cavitary lung lesion

Gastro-oesophageal reflux disease and non-asthma lung disease

Tuberculosis and Nontuberculous Mycobacterial Infections in Older Adults

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