Mycobacterium avium complex pulmonary disease in multidrug-resistant tuberculosis-suspected patients in Mali

Abstract

Background The incidence of nontuberculous mycobacteria is increasing, among them Mycobacterium avium complex (MAC) strains are the most frequently isolated. In countries endemic for tuberculosis, these infections pose a differential diagnosis challenge due to their clinical similarities. Patients and methods The main goal of this study was to describe the epidemiological, clinical aspects, and outcome of patients infected with MAC who met the American thoracic society (ATS) 2007 criteria for MTN disease’s definition. We conducted a 4-year retrospective evaluation from January 2009 to December 2012 at the Pneumophtisiology Department of the Point G University Teaching Hospital in Bamako. Results A total of 17 patients met the criteria for MAC disease, 16 men and one woman with a mean age of 50.4 years. All patients had at least two antituberculosis treatment courses without success. The signs and symptoms were a febrile alteration of physical condition in 41.7% (seven cases), chronic cough in 94.1% (16 cases), dyspnea in 68.7% (11 cases), and hemoptysis in 11.7% (two cases). The sputum smear was positive in 94.1% (16 cases) and the chest radiography showed constant cavitary images associated with nodular lesions in 52.9% (nine cases) or pleurisy in 11.7% (two cases). The evolution was marked by six deaths occurred within an average of 10 months and 10 were loss to follow-up. Conclusion The occurrence of MAC pulmonary disease poses diagnosis and treatment problems with less favorable outcome. Availability of early diagnosis with sputum culture will allow an accurate treatment regimen, which will improve patient outcomes.

Keywords

• chronic tuberculosis
• lung
• Mali
• Mycobacterium avium complex