ethionamide and Lung-Diseases

Mycobacterium kansasii infection is one of the most common causes of nontuberculous mycobacterial lung disease in world. However, little is known about its background characteristics or drug sensitivity in nonendemic areas.. We assessed the clinical features, radiologic findings, and drug sensitivity associated with M kansasii infection in Israel.. Patients with a culture-positive diagnosis of M kansasii infection between April 1999 and April 2004 were identified from a clinic database of tuberculosis centers. Mycobacterial cultures were performed with standard methods. Data on patient background and clinical features were collected from the medical files.. Mean age (+/- SD) of the 56 patients was 58 +/- 18 years, and 64% were men; 59% had associated lung disease. Fifteen percent were receiving immunosuppressive medications. None had HIV infection. Systemic comorbid diseases were noted in 27%. The most common clinical presentations were chest pain, cough, hemoptysis, fever, and night sweats. Cavitation was noted only in 54%. Older patients had more noncavitary disease than younger patients (p = 0.01, r = 0.35). Lower-lobe predominance was very rare (4%). None of the patients presented with pleural effusion or lymphadenopathy. Only seven patients (11%) underwent bronchoscopy for diagnosis. M kansasii isolates showed the highest sensitivity to rifampin, ethambutol, clarithromycin, and ofloxacin, and the highest resistance to ciprofloxacin and capreomycin. The mean duration of treatment was 21 +/- 7.2 months. There were no disease-related deaths.. M kansasii disease in Israel has no association with HIV, more systemic comorbid diseases and associated lung disease, and fewer cavitations. Following appropriate treatment, patients with M kansasii disease have an excellent prognosis.

Topics: Adult; Antibiotics, Antitubercular; Ciprofloxacin; Clarithromycin; Cycloserine; Ethambutol; Ethionamide; Female; Humans; Israel; Lung Diseases; Male; Microbial Sensitivity Tests; Middle Aged; Mycobacterium Infections, Nontuberculous; Mycobacterium kansasii; Ofloxacin; Prognosis; Rifampin

We report a 6 year experience (1979-1984) of isolating Mycobacterium malmoense in the north-east of England. Eleven subjects were involved of whom 10 had active infection--9 pulmonary, one cervical adenitis. The 11 new isolates represent 0.7% of all new mycobacterial isolates during this period and 10% of new non-tuberculous isolates. In all but 2 cases there was pre-existing pulmonary disease and/or a recognised predisposing factor to mycobacterial infection. The organisms were generally insensitive to isoniazid but sensitive to both rifampicin and ethionamide. The results of chemotherapy are described.

Topics: Adult; Drug Therapy, Combination; England; Ethionamide; Female; Humans; Infant; Lung Diseases; Lymphadenitis; Male; Middle Aged; Mycobacterium; Mycobacterium Infections; Rifampin; Tuberculosis, Pulmonary

The clinical records of 7 patients referred to the National Jewish Hospital and Research Center over a 6-year period for evaluation of an abnormal chest x-ray and repeated sputum isolates of rapidly growing mycobacteria (Runyon's Group IV) were reviewed to determine the potential pathogenicity of these organisms. Mycobacterium fortuitum was isolated from 5 patients and Mycobacterium chelonei from 2. Haemoptysis, cough and weight loss were prominent in 6. Three had rheumatoid arthritis. Although two demonstrated cutaneous anergy, lymphocyte responsiveness to PHA was normal. PPD-F was not useful in skin testing or in the in vitro evaluation of lymphocyte function. Histologic examination of the lungs of 2 patients demonstrated caseating granulomata. One patient died of massive pulmonary haemorrhage soon after intiation of therapy. Multi-drug treatment regimens generally resulted in progressive sterilization of the sutum and improvement in the appearance of the chest x-ray. We conclude that some rapidly growing mycobacteria can cause potentially fatal cavitary lung disease and that intensive anti-tuberculosis therapy may successfully alter its course.

Topics: Adult; Aged; Antitubercular Agents; Ethionamide; Female; Humans; Lung Diseases; Male; Microbial Sensitivity Tests; Middle Aged; Mycobacterium; Mycobacterium Infections; Tetracycline

Atypical mycobacterial infections may give rise to various clinical difficulties. Case reports of six patients--three adult patients with pulmonary lesions, two children with cervical lymphadentis and one patient in whom the atypical mycobacterium appeared to be present as a commensal--illustrate these difficulties. Determination of the significance of the organism and differentiation of condition from tuberculosis and others requires consideration of the clinical picture, the results of skin testing, histologic features and cultural characteristics. Three patients, including the two children, were treated with a combination of surgery and chemotherapy, with satisfactory results. An elderly patient with chronic bronchitis and a pulmonary infection due to M. kansasii was treated successfully with antiuberculosis agents alone. Chemotherapy is being tried on a fifth patient with cavitary disease due to M. intracellulare, but is seems likely that an operation will also be required.

Topics: Adult; Aged; Child, Preschool; Cycloserine; Diagnosis, Differential; Ethambutol; Ethionamide; Female; Humans; Isoniazid; Lung; Lung Diseases; Lymph Nodes; Lymphadenitis; Male; Mycobacterium Infections; Skin Tests; Sputum; Tuberculosis, Pulmonary

Topics: Capreomycin; Child; Drug Resistance, Microbial; Ethambutol; Ethionamide; Humans; Isoniazid; Kanamycin; Lung Diseases; Lymphadenitis; Mycobacterium; Mycobacterium Infections; Rifampin; Skin Diseases, Infectious; Sputum; Streptomycin

Topics: Adolescent; Adult; Aged; Aminosalicylic Acids; Antitubercular Agents; Child; Cycloserine; Ethambutol; Ethionamide; Female; Follow-Up Studies; Humans; Isoniazid; Lung Diseases; Male; Middle Aged; Mycobacterium; Mycobacterium Infections; Pneumonectomy; Pyrazinamide; Rifampin; Sputum; Streptomycin

Topics: Adult; Antitubercular Agents; Cycloserine; Drug Combinations; Drug Resistance, Microbial; Ethionamide; Female; Humans; Lung Diseases; Male; Mycobacterium; Mycobacterium Infections; Oxytetracycline; Tetracycline

Topics: Biopsy; Bronchoscopy; Child, Preschool; Diagnosis, Differential; Ethionamide; Female; Humans; Lung Diseases; Mycobacterium; Mycobacterium Infections; Rifampin; Tuberculosis, Pulmonary

Topics: Adolescent; Adult; Albuminuria; Aminosalicylic Acids; Antitubercular Agents; Chronic Disease; Cycloserine; Depression, Chemical; Drug Resistance, Microbial; Eosinophilia; Ethionamide; Headache; Hearing Disorders; Hematuria; Humans; Isoniazid; Kanamycin; Lung Diseases; Middle Aged; Mycobacterium tuberculosis; Pruritus; Pyrazinamide; Respiratory Therapy; Tachycardia; Thiosemicarbazones; Time Factors; Tinnitus; Tuberculosis, Pulmonary; Vertigo; Vestibule, Labyrinth; Viomycin

Topics: Adult; Aged; Drug Resistance, Microbial; Ethionamide; Female; Hospitalization; Humans; Isoniazid; Lung Diseases; Male; Middle Aged; Mycobacterium; Mycobacterium Infections; Prognosis; Radiography; Sputum; Streptomycin

Topics: Cycloserine; England; Environment; Ethionamide; Humans; Lung Diseases; Male; Middle Aged; Mycobacterium; Mycobacterium Infections; Pneumoconiosis; Pulmonary Emphysema; Radiography; Respiratory Tract Infections; Sputum; Tuberculin Test

Topics: Animals; Coal; Dust; Ethambutol; Ethionamide; Guinea Pigs; Isoniazid; Lung Diseases; Mycobacterium; Mycobacterium Infections; Pneumoconiosis; Radiography

Topics: Classification; Cycloserine; Drug Resistance; Drug Resistance, Microbial; Epidemiology; Ethionamide; Humans; Kanamycin; Lung Diseases; Microbiology; Mycobacterium; Mycobacterium Infections; Tuberculosis; Tuberculosis, Pulmonary