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Treatment of Extrapulmonary Nontuberculous Mycobacterial Diseases

机译:肺外非结核分枝杆菌疾病的治疗

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摘要

Nontuberculous mycobacteria (NTM) diseases mainly manifest as pulmonary illnesses, but 20 -30% of NTM isolates originate from extrapulmonary diseases. These diseases cause a variety of clinical syndromes, including skin and soft-tissue infections, musculoskeletal infections, lymphadenitis, and disseminated disease. In skin and soft-tissue infections, musculoskeletal infections, prolonged treatment with combinations of antibiotics is effective in the treatment of NTM diseases, with surgery as an important complementary tool. The recommended duration of therapy for skin and soft-tissue infection is usually 2 – 4 months for mild disease and 6 months for severe disease, while treatment of musculoskeletal NTM disease usually requires at least 6 - 12 months. Management options of NTM lymphadenitis include surgical intervention, medical therapy, or observation. Treatment of disseminated NTM disease generally requires 6 to 12 months after immune restoration. However, despite a considerable increase in knowledge about NTM diseases, determining optimal treatment approaches remains a complex and challenging task.
机译:非结核分枝杆菌(NTM)疾病主要表现为肺部疾病,但20%-30%的NTM分离株起源于肺外疾病。这些疾病引起多种临床综合征,包括皮肤和软组织感染,肌肉骨骼感染,淋巴结炎和传播性疾病。在皮肤和软组织感染,肌肉骨骼感染中,长期使用抗生素组合治疗可有效治疗NTM疾病,而手术则是重要的辅助工具。对于皮肤和软组织感染,建议的治疗时间通常为2至4个月(轻度疾病)和6个月(重度疾病),而肌肉骨骼NTM疾病的治疗通常至少需要6-12个月。 NTM淋巴结炎的管理选择包括外科手术,药物治疗或观察。播散性NTM疾病的治疗通常需要在免疫恢复后6至12个月。但是,尽管对NTM疾病的了解大大增加,但是确定最佳治疗方法仍然是一项复杂而具有挑战性的任务。

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