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Pulmonale Erkrankungen durch nichttuberkulöse Mykobakterien

Pulmonary diseases due to nontuberculous mycobacteria

  • Leitthema
  • Published:
Der Pneumologe Aims and scope

Zusammenfassung

Pulmonale Infektionen durch nichttuberkulöse Mykobakterien (NTM) sind selten und müssen gegenüber Kolonisationen des Tracheobronchialsystems abgegrenzt werden. Bei radiologischem Nachweis infiltrativer, kavernöser oder interstitieller Lungenveränderungen, bei Rundherden oder Bronchiektasen, müssen pulmonale Infektionen mit NTM differenzialdiagnostisch berücksichtigt werden. Die Diagnosestellung einer Infektion durch NTM erfolgt nach zusammenfassender Beurteilung radiologischer, mikrobiologischer, histopathologischer und ggf. molekularbiologischer und immunologischer Befunde. Für eine erfolgreiche Behandlung müssen individuelle Therapiekonzepte mit oft langfristiger kombinierter medikamentöser Behandlung und hohem Anspruch an die Therapieadhärenz der Patienten oder Strategien mit zusätzlichen chirurgischen Interventionen erstellt werden.

Abstract

Pulmonary infections caused by nontuberculous mycobacteria (NTM) are rare and need to be differentiated from colonizations of the tracheobronchial tree by these bacteria. Typical radiological features associated with pulmonary NTM infections include lobar infiltrates, cavitations, interstitial infiltrates, solitary nodules, and bronchiectasis. The diagnosis of NTM infection is made upon consideration of typical clinical, radiological, microbiological, histopathological and if necessary also molecular biological and immunological evaluations. Individualized therapeutic concepts with long-term medical therapy or in combination with surgical interventions are needed for successful treatments.

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Abbreviations

ATS:

American Thoracic Society

BAL:

Bronchoalveoläre Lavage

BCG:

Bacille Calmette Guérin

BTS:

British Thoracic Society

IfsG:

Infektionsschutzgesetz

MAC:

Mycobacterium-avium-Komplex

MTB:

Mycobacterium tuberculosis

NAT:

Nukleinsäureamplifikationstechniken

NTM:

Nichttuberkulöse Mykobakterien

PCR:

Polymerasekettenreaktion

TB:

Tuberkulose

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  1. Klinische Infektiologie, Medizinische Klinik, Forschungszentrum Borstel, Parkallee 35, 23845, Borstel, Deutschland

    U. Greinert & C. Lange

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  1. U. Greinert
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  2. C. Lange
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Correspondence to U. Greinert.

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Greinert, U., Lange, C. Pulmonale Erkrankungen durch nichttuberkulöse Mykobakterien. Pneumologe 4, 409–423 (2007). https://doi.org/10.1007/s10405-007-0162-z

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