Pneumologie meets Infektiologie: Nichttuberkulöse Mykobakteriosen der Lunge

Abstract

BackgroundNontuberculous mycobacterial infections of the lung (NTM-LD) are diseases with a chronic course, that often occur in conjunction with predisposing lung diseases (e.g., chronic obstructive lung disease. COPD, bronchiectasis) and frequently present challenges to physicians and affected patients in clinical practice.ObjectiveAn overview of the epidemiology, diagnostics, and treatment of NTM-LD is presented.Material and methodsThe complexity of the treatment of NTM-LD is outlined based on the current scientific evidence and current guideline recommendations and is illustrated using two exemplary species (Mycobacterium avium complex and M. abscessus).ResultsNTM-LD can occur in variable grades of severity. The diagnosis is based on established clinical, imaging and microbiological criteria. The decision on treatment depends on other co-factors, such as concomitant diseases, detected NTM species, antimicrobial resistance, severity of the disease and expected treatment outcome. In some cases, an approach of watchful waiting can be indicated.ConclusionPulmonary NTM infections require long-term (≥ 12 months), in some cases parenterally administered treatment that is associated with a significant toxicity. For optimal diagnostics and weighing up for or against a form of treatment, early referral of proven or suspected patients to a competence center with experience in treating NTM infections should be carried out.