Clinical features of patients presenting with fever of unknown origin caused by non-tuberculous mycobacterium infection

Introduction: Although non-tuberculous mycobacterium (NTM) infection accounts for only a small proportion of fever of unknown origin (FUO) cases, it has become a more common etiology in recent years. Therefore, we reviewed FUO patients with underlying NTM infection to better understand its clinical...

Full description

Saved in:
Bibliographic Details
Main Authors: Huiting Liu, Ting Zhang, Yu Wang, Hongwei Fan, Xiaoming Huang, Yang Jiao
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2023-07-01
Series:Journal of Infection in Developing Countries
Subjects:
Online Access:https://jidc.org/index.php/journal/article/view/17610
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850148627820838912
author Huiting Liu
Ting Zhang
Yu Wang
Hongwei Fan
Xiaoming Huang
Yang Jiao
author_facet Huiting Liu
Ting Zhang
Yu Wang
Hongwei Fan
Xiaoming Huang
Yang Jiao
author_sort Huiting Liu
collection DOAJ
description Introduction: Although non-tuberculous mycobacterium (NTM) infection accounts for only a small proportion of fever of unknown origin (FUO) cases, it has become a more common etiology in recent years. Therefore, we reviewed FUO patients with underlying NTM infection to better understand its clinical features. Methodology: The medical records of patients presenting with FUO and diagnosed with NTM infection admitted to Peking Union Medical College Hospital between January 2016 and June 2021 were reviewed. The clinical information of patients whose follow-up data were available were summarized. Specimens submitted for pathogenic identification were processed by mycobacterial culture, acid-fast staining, and mycobacterial nucleic acid detection. IBM SPSS Statistics v22.0 (SPSS, Inc., Chicago, IL, USA) was used for data analysis. Results: Fifty-five FUO patients were diagnosed with NTM infection (55/785; 7.0% of FUO cases). Patients were mostly middle-aged men and had a relatively long disease course. Seven, 29, and 54 patients had previously no respondence to glucocorticoids, immunosuppressants, and multiple antibiotics, respectively; their inflammatory indexes were significantly increased; and there was no obvious risk of immunosuppression in this group, who were likely to be T.SPOT-TB negative (33/41; 80.5%). The most commonly identified NTM was Mycobacterium intracellulare followed by Mycobacterium chelonae/abscessus, Mycobacterium kansasii, and Mycobacterium avium. Conclusions: Microbiological investigations including culture, acid-fast staining, NTM nucleic acid examination, and next-generation sequencing were performed to confirm the diagnosis of NTM in FUO patients. FUO patients should screen for NTM infections so that this important etiology can be recognized, targeted treatments administered early, and outcomes improved.
format Article
id doaj-art-0f4a5e0f50ab488f8a52cd459030272a
institution OA Journals
issn 1972-2680
language English
publishDate 2023-07-01
publisher The Journal of Infection in Developing Countries
record_format Article
series Journal of Infection in Developing Countries
spelling doaj-art-0f4a5e0f50ab488f8a52cd459030272a2025-08-20T02:27:11ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802023-07-01170710.3855/jidc.17610Clinical features of patients presenting with fever of unknown origin caused by non-tuberculous mycobacterium infectionHuiting Liu0Ting Zhang1Yu Wang2Hongwei Fan3Xiaoming Huang4Yang Jiao5Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China Introduction: Although non-tuberculous mycobacterium (NTM) infection accounts for only a small proportion of fever of unknown origin (FUO) cases, it has become a more common etiology in recent years. Therefore, we reviewed FUO patients with underlying NTM infection to better understand its clinical features. Methodology: The medical records of patients presenting with FUO and diagnosed with NTM infection admitted to Peking Union Medical College Hospital between January 2016 and June 2021 were reviewed. The clinical information of patients whose follow-up data were available were summarized. Specimens submitted for pathogenic identification were processed by mycobacterial culture, acid-fast staining, and mycobacterial nucleic acid detection. IBM SPSS Statistics v22.0 (SPSS, Inc., Chicago, IL, USA) was used for data analysis. Results: Fifty-five FUO patients were diagnosed with NTM infection (55/785; 7.0% of FUO cases). Patients were mostly middle-aged men and had a relatively long disease course. Seven, 29, and 54 patients had previously no respondence to glucocorticoids, immunosuppressants, and multiple antibiotics, respectively; their inflammatory indexes were significantly increased; and there was no obvious risk of immunosuppression in this group, who were likely to be T.SPOT-TB negative (33/41; 80.5%). The most commonly identified NTM was Mycobacterium intracellulare followed by Mycobacterium chelonae/abscessus, Mycobacterium kansasii, and Mycobacterium avium. Conclusions: Microbiological investigations including culture, acid-fast staining, NTM nucleic acid examination, and next-generation sequencing were performed to confirm the diagnosis of NTM in FUO patients. FUO patients should screen for NTM infections so that this important etiology can be recognized, targeted treatments administered early, and outcomes improved. https://jidc.org/index.php/journal/article/view/17610Fever of unknown originnon-tuberculous mycobacterium infectiondiagnosisclinical characteristics
spellingShingle Huiting Liu
Ting Zhang
Yu Wang
Hongwei Fan
Xiaoming Huang
Yang Jiao
Clinical features of patients presenting with fever of unknown origin caused by non-tuberculous mycobacterium infection
Journal of Infection in Developing Countries
Fever of unknown origin
non-tuberculous mycobacterium infection
diagnosis
clinical characteristics
title Clinical features of patients presenting with fever of unknown origin caused by non-tuberculous mycobacterium infection
title_full Clinical features of patients presenting with fever of unknown origin caused by non-tuberculous mycobacterium infection
title_fullStr Clinical features of patients presenting with fever of unknown origin caused by non-tuberculous mycobacterium infection
title_full_unstemmed Clinical features of patients presenting with fever of unknown origin caused by non-tuberculous mycobacterium infection
title_short Clinical features of patients presenting with fever of unknown origin caused by non-tuberculous mycobacterium infection
title_sort clinical features of patients presenting with fever of unknown origin caused by non tuberculous mycobacterium infection
topic Fever of unknown origin
non-tuberculous mycobacterium infection
diagnosis
clinical characteristics
url https://jidc.org/index.php/journal/article/view/17610
work_keys_str_mv AT huitingliu clinicalfeaturesofpatientspresentingwithfeverofunknownorigincausedbynontuberculousmycobacteriuminfection
AT tingzhang clinicalfeaturesofpatientspresentingwithfeverofunknownorigincausedbynontuberculousmycobacteriuminfection
AT yuwang clinicalfeaturesofpatientspresentingwithfeverofunknownorigincausedbynontuberculousmycobacteriuminfection
AT hongweifan clinicalfeaturesofpatientspresentingwithfeverofunknownorigincausedbynontuberculousmycobacteriuminfection
AT xiaominghuang clinicalfeaturesofpatientspresentingwithfeverofunknownorigincausedbynontuberculousmycobacteriuminfection
AT yangjiao clinicalfeaturesofpatientspresentingwithfeverofunknownorigincausedbynontuberculousmycobacteriuminfection