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Mycobacterium Fortuitum Treatment & Management

  • Author: Joseph M Fritz, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
 
Updated: Oct 05, 2015
 

Medical Care

Local wound care for cutaneous lesions is always appropriate. Small lesions may improve with local care and antibiotics without surgical intervention.

In vitro susceptibilities may not correlate with in vivo activities. Before considering major surgery, a course of at least 2 drugs may be useful, even with resistant organisms.

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Surgical Care

Surgical debridement of cutaneous or subcutaneous lesions, especially if the lesions are extensive, is usually required for cure.

Surgical debridement of ocular and bone lesions is almost always required.

Surgical excision of pulmonary lesions may be considered if response to therapy is lacking or if the organism is relatively resistant to antibiotics.

Surgical excision of lymphadenitis is the therapy of choice and is usually curative.

If the infection involves an implanted device, removal of the device is usually necessary for cure.

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Consultations

Obtain consultation with an infectious diseases specialist for diagnostic and therapeutic guidance.

Obtain consultation with a pulmonologist for lung lesions, for possible bronchoscopy, and for therapeutic guidance.

Obtain consultation with a surgeon for debridement and/or biopsy. Indwelling catheter placement may also be necessary if long-term antibiotics are to be administered.

Obtain consultation with a dermatologist for possible biopsy of cutaneous lesions.

If local expertise in NTM infections is not available, consider obtaining expert advice from a national center, such as the National Jewish Medical and Research Center in Denver, Colo, or a regional medical school, such as the Mycobacterial Disease Clinic at The University of Texas Health Center at Tyler.

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Contributor Information and Disclosures
Author

Joseph M Fritz, MD Fellow, Division of Infectious Diseases, Washington University School of Medicine, Barnes Jewish Hospital

Joseph M Fritz, MD is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of America, Society for Healthcare Epidemiology of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Aaron Glatt, MD Chief Administrative Officer, Executive Vice President, Mercy Medical Center, Catholic Health Services of Long Island

Aaron Glatt, MD is a member of the following medical societies: American College of Chest Physicians, American Association for Physician Leadership, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Medical Association, American Society for Microbiology, American Thoracic Society, American Venereal Disease Association, Infectious Diseases Society of America, International AIDS Society, Society for Healthcare Epidemiology of America

Disclosure: Nothing to disclose.

Chief Editor

Pranatharthi Haran Chandrasekar, MBBS, MD Professor, Chief of Infectious Disease, Program Director of Infectious Disease Fellowship, Department of Internal Medicine, Wayne State University School of Medicine

Pranatharthi Haran Chandrasekar, MBBS, MD is a member of the following medical societies: American College of Physicians, American Society for Microbiology, International Immunocompromised Host Society, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Additional Contributors

Klaus-Dieter Lessnau, MD, FCCP Clinical Associate Professor of Medicine, New York University School of Medicine; Medical Director, Pulmonary Physiology Laboratory; Director of Research in Pulmonary Medicine, Department of Medicine, Section of Pulmonary Medicine, Lenox Hill Hospital

Klaus-Dieter Lessnau, MD, FCCP is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Medical Association, American Thoracic Society, Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Acknowledgements

Keith F Woeltje, MD, PhD Professor, Department of Internal Medicine, Division of Infectious Diseases, Washington University School of Medicine

Keith F Woeltje, MD, PhD is a member of the following medical societies: American College of Physicians, American Medical Informatics Association, Infectious Diseases Society of America, and Society for Healthcare Epidemiology of America

Disclosure: Nothing to disclose.

References
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