title: Pulmonary and Vertebral Mycobacterium avium Disease in a HIV-negative 71-year-old Man - A Case Report.
abstract: Nontuberculous mycobacteria (NTM) caused pulmonary disease is on increase worldwide, especially in countries with decreasing time trend of tuberculosis incidence. NTM skeletal affection is rare. Mycobacterium avium related disease, with still unclear clinical and radiologic features, is in current focus of both clinicians and researchers. An exhausted severely ill 71-year-old man was admitted on emergency due to cough, dyspnea and lumbar back pain to be diagnosed with terminal phase M. avium disease. Three sputum smears were positive for acid fast bacilli and M. avium was identified with hybridization reaction by means of GenoType ® MTBC (Hain). Apart from pulmonary disease, compressive fractures of the 12th thoracic and 1-4th lumbar vertebrae were detected. We found age, chronic alcoholism, previous professional exposure, tobacco smoking, chronic obstructive pulmonary disease and previous tuberculosis as risk factors for NTM disease in the HIV-negative patient. Despite combined antibiotic treatment, disease had lethal outcome. This case report might contribute to clinicians' awareness and improved knowledge on this sort of pathology, and lead to earlier diagnosis with possibly better disease outcome.
authors.affiliation: Clinical Center of Serbia, Teaching Hospital of Pulmonology, Belgrade, Serbia.
authors.forename: Mihailo I
authors.initials: MI
authors.lastname: Stjepanovic
authors.affiliation: Clinical Center of Serbia, Teaching Hospital of Pulmonology, Belgrade, Serbia; University of Belgrade, School of Medicine, Belgrade, Serbia.
authors.forename: Dragica P
authors.initials: DP
authors.lastname: Pesut
authors.affiliation: University of Belgrade, School of Medicine, Belgrade, Serbia; Clinical Center of Serbia, Teaching Hospital of Orthopedic Surgery and Traumatology, Belgrade, Serbia.
authors.forename: Aleksandar R
authors.initials: AR
authors.lastname: Lesic
authors.affiliation: University of Belgrade, School of Medicine, Belgrade, Serbia;Center of Radiologic Diagnostics and Magnetic Resonance, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Ruza S
authors.initials: RS
authors.lastname: Stevic
mesh_terms: D000368:Aged; D017291:Clarithromycin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004977:Ethambutol / Q000627:therapeutic use; D017809:Fatal Outcome; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications*; D009162:Mycobacterium avium / Q000302:isolation & purification*; D012131:Respiratory Insufficiency / Q000382:microbiology; D012293:Rifampin / Q000627:therapeutic use; D012307:Risk Factors; D013122:Spinal Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D013183:Sputum / Q000382:microbiology
chemical_list: D004977:Ethambutol; D017291:Clarithromycin; D012293:Rifampin