title: Radiologic computed tomography features of Mycobacterium abscessus in cystic fibrosis.
abstract: BACKGROUND
  Mycobacterium abscessus infection in cystic fibrosis (CF) patients can lead to poor outcomes. Early diagnosis is important, but there are no studies outlining specific imaging features of M. abscessus in CF.
  
  
  OBJECTIVE
  To describe the computed tomography (CT) findings of early M. abscessus infection in our CF population.
  
  
  METHODS
  Thirteen CF patients with sputum cultures positive for M. abscessus from 2006 to 2013 were identified at our institution. Clinical characteristics including culture dates and lung function were reviewed. Positive cultures were classified as "disease" versus "colonization" based on published criteria. Chest CT scans were reviewed at times closest to initial infection, and features including bronchiectasis, mucous plugging, consolidation, ground glass opacities, nodules, and cavitation were evaluated. Brody scores were calculated to evaluate extent of CF lung disease.
  
  
  RESULTS
  All patients had bronchiectasis and mucous plugging, with 10 of 13 (76.9%) in an upper lobe distribution. Consolidation was seen in 12 of 13 (92.3%) patients, 8 (61.5%) patients had nodules, and 5 (38.5%) with cavitation. The average Brody score was 59.5, which was no different than previously described CF cohorts without M. abscessus. There were no significant differences between subjects with disease versus colonization.
  
  
  CONCLUSIONS
  The most common CT features of early M. abscessus in our CF population include bronchiectasis, mucus plugging, and consolidation, but the findings did not reveal a unique radiologic signature. CT at this initial time point may not distinguish early M. abscessus infection from background lung disease or mycobacterial colonization in CF patients.
authors.affiliation: Department of Radiology, University of Washington School of Medicine, Seattle, WA, 98195, USA.
authors.forename: Diana L
authors.initials: DL
authors.lastname: Lam
authors.affiliation: Department of Pulmonary and Critical Care Medicine, University of Washington School of Medicine, Seattle, WA, 98195, USA.
authors.forename: Siddhartha G
authors.initials: SG
authors.lastname: Kapnadak
authors.affiliation: Department of Radiology, University of Washington School of Medicine, Seattle, WA, 98195, USA.
authors.forename: J David
authors.initials: JD
authors.lastname: Godwin
authors.affiliation: Department of Radiology, University of Washington School of Medicine, Seattle, WA, 98195, USA.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Kicska
authors.affiliation: Department of Pulmonary and Critical Care Medicine, University of Washington School of Medicine, Seattle, WA, 98195, USA.
authors.forename: Moira L
authors.initials: ML
authors.lastname: Aitken
authors.affiliation: Department of Radiology, University of Washington School of Medicine, Seattle, WA, 98195, USA.
authors.forename: Sudhakar N
authors.initials: SN
authors.lastname: Pipavath
mesh_terms: D000293:Adolescent; D000328:Adult; D001987:Bronchiectasis / Q000150:complications / Q000000981:diagnostic imaging; D003550:Cystic Fibrosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000382:microbiology* / Q000503:physiopathology; D005260:Female; D005541:Forced Expiratory Volume; D005838:Genotype; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000473:pathology; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000382:microbiology*; D000073358:Mycobacterium abscessus / Q000302:isolation & purification*; D012189:Retrospective Studies; D013183:Sputum / Q000382:microbiology; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
keywords: computed tomography; cystic fibrosis, Mycobacterium abscessus