Zusammenfassung
Disseminierte Infektionen mit nichttuberkulösen Mykobakterien (NTM) können bei HIV-infizierten Patienten lebensbedrohlich verlaufen. Häufig finden sich jedoch andere NTM-assoziierte Krankheitsbilder, die sich als pulmonale Erkrankung, extrapulmonale lokale Infektionen oder als ein Immunrekonstitutionssyndrom (IRIS) manifestieren. Zudem sind kutane und subkutane Phänomene bei systemischen NTM-Infektionen beschrieben. Rein kutane NTM-Infektionen werden v. a. von M. marinum und M. ulcerans verursacht, deren Zusammenhang mit einer HIV-Infektion nicht belegt ist. Der vorliegende Beitrag soll Dermatologen, die HIV-Patienten behandeln, eine Übersicht über diese vielfältige Gruppe von Mykobakterien vermitteln. Mit dem Schwerpunkt auf disseminierte, kutane und extrapulmonale Erscheinungsbilder werden Diagnostik, Therapie und Prognose der NTM diskutiert.
Abstract
Disseminated infections with non-tuberculous mycobacteria (NTM) are a life-threatening AIDS-defining illness. Localized infections include pulmonary and extra-pulmonary disease as well as the immune reconstitution inflammatory syndrome (IRIS). Furthermore cutaneous and subcutaneous manifestations of systemic NTM-Infections have been reported. Skin infections without involvement of other anatomical regions are predominantly caused by M. marinum and M. ulcerans. No association with HIV is proven for these two species. This article summarizes the diseases caused by this heterogeneous group of bacteria. The focus is on disseminated disease, dermatological manifestations and extra-pulmonary localized infections. Diagnostic challenges, therapeutic strategies and prognosis of NTM-infections are discussed.
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Herzmann, C., Esser, S. & Lange, C. Infektionen mit nichttuberkulösen Mykobakterien bei HIV-infizierten Patienten. Hautarzt 62, 272–279 (2011). https://doi.org/10.1007/s00105-010-2104-7
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DOI: https://doi.org/10.1007/s00105-010-2104-7