eMedicine Specialties > Infectious Diseases > Mycobacterial Infections

Mycobacterium gordonae: Differential Diagnoses & Workup

Author: 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
Coauthor(s): Cynthia de Luise, PhD, MPH, Director, Epidemiology, Pfizer, Inc
Contributor Information and Disclosures

Updated: Nov 13, 2009

Differential Diagnoses

Mycobacterium Avium-Intracellulare
Mycobacterium Xenopi
Mycobacterium Fortuitum
Tuberculosis
Mycobacterium Haemophilum
Mycobacterium Kansasii
Mycobacterium Marinum

Other Problems to Be Considered

Acquired immunodeficiency syndrome
Nontuberculous mycobacteria infection
Pseudo-outbreak
Colonization
Saprophyte
Contaminant

Workup

Laboratory Studies

  • Documentation of M gordonae disease
  • Microbiologic characteristics
    • Smear-positive specimens for acid-fast bacilli
    • Isolation of organism in large numbers, quantified as growth per culture in colony-forming units (ie, >100)
    • Repeated isolation of M gordonae (ie, more than twice)
    • Detection of specific biochemical characteristics (to prove identity)
    • Consideration of confirmation from a reference laboratory
  • Isolation of M gordonae from a sterile source
  • Positive result from tissue culture
  • Histopathologic changes characteristic of M gordonae infection
  • Repeat mycobacterial cultures of sputum, blood, bone marrow, and urine (if disease is suspected)
  • Blood cultures to determine presence of mycobacterial organisms

Imaging Studies

  • Obtain a chest radiograph in patients with respiratory symptoms.
  • Use CT scanning of the lungs, abdomen, or both to evaluate for possible dissemination.
  • Consider performing abdominal ultrasonography.

Procedures

  • Fiberoptic bronchoscopy helps evaluate for infiltrates.
  • Consider obtaining biopsy specimens (eg, from bone marrow) to help diagnose possible dissemination.

Histologic Findings

Acid-fast stains are positive for M gordonae, and/or granulomas are present.

More on Mycobacterium gordonae

Overview: Mycobacterium gordonae
Differential Diagnoses & Workup: Mycobacterium gordonae
Treatment & Medication: Mycobacterium gordonae
Follow-up: Mycobacterium gordonae
References

References

  1. Lalande V, Barbut F, Varnerot A, Febvre M, Nesa D, Wadel S, et al. Pseudo-outbreak of Mycobacterium gordonae associated with water from refrigerated fountains. J Hosp Infect. May 2001;48(1):76-9. [Medline].

  2. American Thoracic Society. Diagnosis and treatment of disease caused by nontuberculous mycobacteria. This official statement of the American Thoracic Society was approved by the Board of Directors, March 1997. Medical Section of the American Lung Association. Am J Respir Crit Care Med. Aug 1997;156(2 Pt 2):S1-25. [Medline].

  3. Jun HJ, Jeon K, Um SW, Kwon OJ, Lee NY, Koh WJ. Nontuberculous mycobacteria isolated during the treatment of pulmonary tuberculosis. Respir Med. Dec 2009;103(12):1936-40. [Medline].

  4. Konishi M, Uno K, Kasahara K, Mori K, Yoshimoto E, Maeda K, et al. [A case of pulmonary Mycobacterium gordonae infection progressed for no therapy]. Nihon Kokyuki Gakkai Zasshi. May 2007;45(5):436-40. [Medline].

  5. Lessnau KD, Milanese S, Talavera W. Mycobacterium gordonae: a treatable disease in HIV-positive patients. Chest. Dec 1993;104(6):1779-85. [Medline].

  6. Sneath PH, Mair NS, Sharpe ME, eds. The Mycobacteria. Genus Mycobacterium. In: Bergey's Manual of Systematic Bacteriology. Vol 2. 2nd ed. Baltimore, Md: Williams & Wilkins; 1986:1447.

  7. Sánchez-Morgado JM, Gallagher A, Johnson LK. Mycobacterium gordonae infection in a colony of African clawed frogs (Xenopus tropicalis). Lab Anim. Jul 2009;43(3):300-3. [Medline].

  8. Umeda Y, Matsuno Y, Imaizumi M, Mori Y, Iwata H, Takiya H. Extralobar pulmonary sequestration infected with Mycobacterium gordonae. J Thorac Cardiovasc Surg. Jan 2009;137(1):e23-4. [Medline].

  9. Weinberger M, Berg SL, Feuerstein IM, Pizzo PA, Witebsky FG. Disseminated infection with Mycobacterium gordonae: report of a case and critical review of the literature. Clin Infect Dis. Jun 1992;14(6):1229-39. [Medline].

Further Reading

Keywords

tap water bacillus, tap water isolate, tap water bacteremia, nontuberculous mycobacteria, mycobacteria, non-tuberculous mycobacteria

Contributor Information and Disclosures

Author

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 Society for Artificial Internal Organs, American Thoracic Society, Physicians for Social Responsibility, and Society of Critical Care Medicine
Disclosure: sepracor Ownership interest None

Coauthor(s)

Cynthia de Luise, PhD, MPH, Director, Epidemiology, Pfizer, Inc
Cynthia de Luise, PhD, MPH is a member of the following medical societies: American Academy of Physician Assistants, American Public Health Association, and International Society for Pharmacoepidemiology
Disclosure: Pfizer Salary Employment

Medical Editor

Thomas Herchline, MD, Professor of Medicine, Wright State University Boonshoft School of Medicine; Medical Director, Public Health, Dayton and Montgomery County, Ohio
Thomas Herchline, MD is a member of the following medical societies: American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Aaron Glatt, MD, Professor of Clinical Medicine, New York Medical College; President and CEO, Former Chief Medical Officer, Departments of Medicine and Infectious Diseases, New Island Hospital
Aaron Glatt, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physician Executives, 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, and Society for Healthcare Epidemiology of America
Disclosure: Nothing to disclose.

CME Editor

Eleftherios Mylonakis, MD, Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital
Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD, Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital
Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

 
 
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