Mycobacterium Fortuitum Treatment & Management
- Author: Joseph M Fritz, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD more...
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.
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.
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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