Non-tuberculous mycobacteriosis of the lungs - comorbid pathology

<b>Aim:</b> To determine the characteristics of chronic lung diseases in patients with mycobacterioses caused by slowly growing nontuberculous mycobacteria (NTM). We studied 72 patients with pulmonary mycobacterioses caused by slowly growing NTM; the average age was 56.8±0.3 yrs; disease duration was 22±0.5 months. In all patients the diagnosis was microbiologically verified. Out of them 36 (51%) were infected with M. avium, 23.6% – M. intracellulare, 8.3 – M. kansasii, 4.2% – M. xenopi, 4.2% – M. lentiflavum, 2.7% – M. gordonae. Four patients were co-infected with M. avium + M. intracellulare. We studied clinical and radiological patterns of mycobacterioses and concomitant lung diseases. According to HRCT, in 8 (11.1%) patients mycobacteriosis proceeded as a restricted form (a focus or a tuberculoma). In 64 (88.3%) it was associated with a chronic lung disease: in 37.5% – with chronic bronchitis and bronchiectasis; 23.6% – TB, 27.7% – COPD, 22.2% – bronchoectatic disease (BED) and cystic fibrosis, 6.9% – granulematous lung diseases, 8.3% – lung cancer and cancer of other localizations. In 9 (12.5%) patients we observed mycobacteriosis associated with more than one lung disease: TB+BED, COPD+TB. Radiological patterns of mycobacterioses caused by slowly growing NTM were as follows: focal changes – 76.4%, bronchiectasis – 69.4%, bronchiectasis with infiltration of the surrounding lung tissue – 55.5%. Different degree fibrotic and cirrhotic changes were observed in 34.7%. Cavities were registered in 25% (infected with M. avium, M. kansasii, M. intracellulare), though morphologically they were referred to giant bronchiectasis.