Preview

Tuberculosis and Lung Diseases

Advanced search

Pulmonary mycobacterioses: surgical aspects of diagnostics and treatment

https://doi.org/10.21292/2075-1230-2016-94-5-18-26

Abstract

Goal: to investigate efficiency of surgical diagnostics and treatment of pulmonary mycobacteriosis.

Materials and methods: 31 patients diagnosed with pulmonary mycobacteriosis underwent surgery. Should mycobacteriosis be not diagnosed before the surgical intervention, the surgery was performed as per standard indications for fibrous cavernous pulmonary tuberculosis or tuberculoma.

Results. There were 20 segmental resections, 4 lobectomies (with  МАС-, M. kansasii-infection), 5 pneumonectomies (with  M. xenopi and M. fortuitum-infection), 2 combined resections. The causative agent was isolated out of surgical specimens in 11 (35.4%) patients; in 10 patients (32.3%) mycobacteriosis was confirmed by detection of non-tuberculous mycobacteria in sputum or bronchial lavage along with the detection of the causative agent in the resected tissue. In the remaining 10 (32.3%) patients non-tuberculous mycobacteria were detected only in sputum and/or bronchial lavage before surgical interventions. Post-surgery complications were observed in 6 (19.4%) of patients, lethal outcome due to myocardial infarction. Clinical cure was achieved in 29 (93.6%) patients. 

About the Authors

L. D. Guntupova
Moscow Municipal Scientific Practical Center of Tuberculosis Control, Health Department of Moscow
Russian Federation

TB Doctor of Municipal Clinical Diagnostic Center,

10, Stromynka St., Moscow, 107014



S. E. Borisov
Moscow Municipal Scientific Practical Center of Tuberculosis Control, Health Department of Moscow
Russian Federation

Deputy Director for Research and Clinical Activities,

10, Stromynka St., Moscow, 107014



P. A. Dreval
Moscow Municipal Scientific Practical Center of Tuberculosis Control, Health Department of Moscow
Russian Federation

Thoracic Surgeon of the 2nd Surgical Department, Clinic no. 1,

10, Stromynka St., Moscow, 107014



A. A. Vorobiev
Moscow Municipal Scientific Practical Center of Tuberculosis Control, Health Department of Moscow
Russian Federation

Deputy Chief Doctor for Thoracic Surgery,

10, Stromynka St., Moscow, 107014



Yu. D. Isaeva
Moscow Municipal Scientific Practical Center of Tuberculosis Control, Health Department of Moscow
Russian Federation

Researcher of Department of Laboratory Diagnostics of Tuberculosis and Pathomorphology,

10, Stromynka St., Moscow, 107014



References

1. Guntupova L.D., Borisov S.E., Makarova M.V. et al. Respiratory mycobacteriosis: epidemiology, microbiological and clinical aspects of diagnostics. Epidemiologiya i Infektsionnye Bolezni, 2012, no. 2, pp. 8-14. (In Russ.)

2. Guntupova L.D., Borisov S.E., Solovieva I.P. et al. Clinical and morphological description of pulmonary mycobacteriosis. Arkhiv Patologii, 2011, no. 5 (73), pp. 12-16. (In Russ.)

3. Makarova M.V. Vydeleniye i identifikatsiya netuberkuleznykh mikobaktery u patsientov ftiziatricheskikh uzrezhdeniy. Diss. dokt. med. nauk. [Isolation and identification of non-tuberculous mycobacteria in the patients in tuberculosis units. Doct. Diss.]. Moscow, 2010, 48 p.

4. ICD-10. (International Classification of Diseases). 2003, 924 p. (In Russ.)

5. Otten T.F., Fomenkova N.V., Mayskaya M.Yu. et al. The AIDS patient suffering from generalized mycobacteriosis. Tub., 2015, no. 8, pp. 57-62. (In Russ.)

6. Repin Yu.M. Lekarstvenno-ustoychivy tuberkulyoz lyogkikh. Khirurgicheskoye lecheniye. [Drug resistant pulmonary tuberculosis. Surgical treatment]. St. Peterburg, Gippokrat Publ., 2007, 168 p.

7. Dailloux M., Abalain M., Laurain C. et al. Respiratory infections associated with nontuberculous mycobacteria in non-HIV patients. Eur. Respir. J., 2006, vol. 28, pp. 1211-1215.

8. Daley C. Mycobacterial infections. Semin. Respir. Crit. Care Med., 2013, vol. 34, no. 1, pp. 1-22.

9. Ellis S.M., Hansell D.M. Imaging of nontuberculous (atypical) mycobacterial pulmonary infection. Clin. Radiol., 2002, vol. 57, pp. 661-669.

10. Griffith D.E., Aksamit T., Brown-Elliott B. A. et al. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am. J. Respir. Crit. Care Med., 2007, vol. 175, pp. 367-416.

11. Horsburgh C.R. Epidemiology of Mycobacterium avium complex. In: Korvick J. A., Benson C. A. Mycobacterium avium сomplex infection: Progress in Research and Treatment. New York, NY: Marcel Dekker. 1996, pp. 1-22.

12. Johnson M.M., Odell J.A. Nontuberculous mycobacterial pulmonary infections. J. Thorac. Dis., 2014, 6, no. 3, pp. 210-219.

13. Kendall B., Winthrop K. Update on the epidemiology of pulmonary nontuberculous mycobacterial infections. Semin. Respir. Crit. Care Med., 2013, vol. 34, no. 1, pp. 87-94.

14. Koh W., Kwon O., Lee K. Diagnosis and treatment of nontuberculous mycobacterial pulmonary diseases. J. Korean Med. Sci., 2005, 20, no. 6, pp. 913-925.

15. Koh W.J., Kim Y.H., Kwon O.J. Surgical Treatment of Pulmonary Diseases Due to Nontuberculous Mycobacteria. J. Korean Med. Sci., 2008, vol. 23, no. 3, pp. 397-401.

16. McGrath E.E., Anderson P.B. The therapeutic approach to non-tuberculous mycobacterial infection of the lung. Department of Respiratory Medicine, Northern General Hospital, Sheffield, UK. 2010, vol. 23, no. 5, pp. 389-396. Abstract. 17. Mitchell J.D., Bishop A., Cafaro A. et al. Anatomic lung resection for nontuberculous mycobacterial disease. Ann. Thorac. Surg., 2008, vol. 85, no. 6, pp. 1887-1892.

17. Sherwood J.T., Mitchell J.D., Pomerantz M. Completion pneumonectomy for chronic mycobacterial disease. J. Thorac. Cardiovasc. Surg., 2005, 129, no. 6, pp. 1258-1265.

18. Shiraishi Y., Nakajima Y., Katsuragi N. et al. Pneumonectomy for nontuberculous mycobacterial infections. Ann. Thorac. Surg., 2004, vol. 78, no. 2, pp. 399-403.

19. Tortoli E. Clinical manifestation of nontuberculous mycobacterial infections. Clin. Microbiol. Infect., 2009, vol. 15, no. 10, pp. 906-910.

20. Van Ingen J. Diagnosis of nontuberculous mycobacterial infections. Semin. Respir. Crit. Care Med., 2013, vol. 34, no. 1, pp. 103-109.

21. Von Rhein C.F., Arbeit R.D., Horsburgh R. et al. Sources of disseminated Mycobacterium avium infection in AIDS. J. Infect., 2002, vol. 44, pp. 166-170.

22. Von Rhein C.F., Waddell R.D., Eaton T. et al. Isolation of Mycobacterium avium complex from water in the United States, Finland, Zaire, and Kenya. J. Clin. Microbiol., 1993, vol. 12, pp. 3227-3230.


Review

For citations:


Guntupova L.D., Borisov S.E., Dreval P.A., Vorobiev A.A., Isaeva Yu.D. Pulmonary mycobacterioses: surgical aspects of diagnostics and treatment. Tuberculosis and Lung Diseases. 2016;94(5):18-26. (In Russ.) https://doi.org/10.21292/2075-1230-2016-94-5-18-26

Views: 2730


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2075-1230 (Print)
ISSN 2542-1506 (Online)