Nontuberculous mycobacterial osteomyelitis
| Autor: | Jun-Jie Li, Mei Deng, Hai-Ying Yu, Haiyang Hu, Sheng Bi, Bei-Wen Zheng, Jifang Sheng, Kaijin Xu, Fei-Shu Hu, Zhongkang Ji |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
nontuberculous mycobacteria Microbiology (medical) Poor prognosis medicine.medical_specialty Necrosis medicine.medical_treatment Mycobacterium Infections Nontuberculous Review Article Diabetes Complications Bone Infection Pathogenesis Immunocompromised Host Interferon-gamma Humans Medicine Chemotherapy General Immunology and Microbiology biology Combined antibiotics Tumor Necrosis Factor-alpha business.industry Osteomyelitis HIV General Medicine bacterial infections and mycoses biology.organism_classification medicine.disease Interleukin-12 Dermatology Infectious Diseases diabetes mellitus Immunology Nontuberculous mycobacteria Disease Susceptibility medicine.symptom business |
| Zdroj: | Infectious Diseases (London, England) |
| ISSN: | 2374-4243 2374-4235 |
| Popis: | Osteomyelitis caused by nontuberculous mycobacteria (NTM) can have severe consequences and a poor prognosis. Physicians therefore need to be alert to this condition, especially in immunocompromised patients. Although the pathogenesis of NTM osteomyelitis is still unclear, studies in immunodeficient individuals have revealed close relationships between NTM osteomyelitis and defects associated with the interleukin-12–interferon-γ–tumor necrosis factor-α axis, as well as human immunodeficiency virus infection, various immunosuppressive conditions, and diabetes mellitus. Culture and species identification from tissue biopsies or surgical debridement tissue play crucial roles in diagnosing NTM osteomyelitis. Suitable imaging examinations are also important. Adequate surgical debridement and the choice of appropriate, combined antibiotics for long-term anti-mycobacterial chemotherapy, based on in vitro drug susceptibility tests, are the main therapies for these bone infections. Bacillus Calmette–Guerin vaccination might have limited prophylactic value. The use of multiple drugs and long duration of treatment mean that the therapeutic process needs to be monitored closely to detect potential side effects. Adequate duration of anti-mycobacterial chemotherapy together with regular monitoring with blood and imaging tests are key factors determining the recovery outcome in patients with NTM osteomyelitis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|