Mycobacterium Fortuitum Follow-up
- Author: Joseph M Fritz, MD; Chief Editor: Burke A Cunha, MD more...
Further Inpatient Care
- Many, if not most, patients do not require inpatient care. The duration of inpatient care is dictated by the time needed to recover from any procedures performed.
Further Outpatient Care
- The frequency of outpatient visits is determined by the extent of the disease and whether the patient is receiving oral or intravenous therapy.
- Initially, at least monthly follow-up care for adverse effects is reasonable.
- More frequent visits may be necessary for patients with central catheters to evaluate for line infections.
- Outpatients taking aminoglycoside therapy should undergo periodic (at least weekly) assessment of renal function and, possibly, antibiotic levels.
- Monthly sputum cultures may be useful in patients with pulmonary disease to demonstrate the efficacy of the treatment plan.
Inpatient & Outpatient Medications
- Administer antibiotics daily (see Medication).
- Infrequent dosing (eg, 2-3 times/wk, as for tuberculosis) has not been evaluated and is not recommended.
Transfer
- Patients who require intravenous antibiotic therapy but who are unable to receive home intravenous therapy need to be placed in a facility capable of administering antibiotics.
- Patients with refractory disease may require a referral to a specialty center (usually as an outpatient rather than as an inpatient transfer).
Deterrence/Prevention
- No specific deterrence methods are available. M fortuitum is a ubiquitous organism.
Complications
- Severe lung disease or disseminated disease may cause death.
- Skin lesions and subsequent debridement may be disfiguring.
- Antibiotic monotherapy may lead to drug resistance.
Prognosis
- With debridement and antibiotic therapy, prognosis is very good for most sites of infection.
- Lung disease may be difficult or impossible to eradicate. Chronic suppression of the infection and slowing of the progression of lung disease may be the only achievable goal in this setting.
- Cure of infected implants that cannot be removed may be impossible.
Patient Education
- Educate patients about the importance of compliance with multiple drug regimens to avoid development of antibiotic resistance.
- Patients may confuse the disease with tuberculosis and need to be reassured that they are not contagious to others.
- For excellent patient education resources, visit eMedicine's Procedures Center. Also, see eMedicine's patient education article Bronchoscopy.
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