Mycobacterium Xenopi Clinical Presentation

  • Author: Mansoor Arif, MD, MBBS; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Apr 24, 2012
 

History

Infection with M xenopi may result in pulmonary infection, usually in older adults with COPD, in patients who are immunocompromised with disseminated disease, or in patients with extrapulmonary disease involving the lymphatic system, skin, bones, or joints.[3, 4] Onset of symptoms is insidious, and the infection may progress slowly or increase and decrease over the course of months or years.

Presenting symptoms

  • Chronic productive cough (90%)
  • Dyspnea (80%)
  • Constitutional symptoms such as weakness, malaise, and weight loss (90%)
  • Hemoptysis (20%)
  • Night sweats (20%)
  • Fever (10%)

Presenting symptoms of immunocompromised patients with disseminated disease

  • Prolonged febrile illness (95%)
  • Wasting syndrome (95%)

Possible presenting symptoms of patients with HIV infection

  • Advanced disease
  • Low CD4+ cell counts (< 50/µL)
  • Prior AIDS-defining illness
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Physical

Physical findings relate to underlying long-term illness and are not specific for M xenopi infection. More than 95% of patients have abnormal lung findings.

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Causes

Predisposing factors include the following:

  • Preexisting lung disease (eg, COPD, bronchiectasis)
  • Pulmonary or extrapulmonary malignancy
  • Alcoholism
  • Diabetes mellitus
  • Immunocompromised state (eg, HIV infection, AIDS)
  • Exposure via inhalation of aerosolized water infected with M xenopi or contact with infected water droplets

Sirolimus therapy inhibits interleukin 12–induced proliferation of activated T lymphocytes and may be a risk factor.

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Contributor Information and Disclosures
Author

Mansoor Arif, MD, MBBS  Research Associate, Department of Research, Indus Hospital, Pakistan

Disclosure: Nothing to disclose.

Coauthor(s)

Syed Faisal Mahmood, MBBS  Assistant Professor of Infectious Diseases, Department of Medicine, Aga Khan University Hospital, Pakistan

Disclosure: Nothing to disclose.

Specialty Editor Board

Wesley W Emmons, MD, FACP  Assistant Professor, Department of Medicine, Thomas Jefferson University; Consulting Staff, Infectious Diseases Section, Department of Internal Medicine, Christiana Care, Newark, DE

Wesley W Emmons, MD, FACP is a member of the following medical societies: American College of Physicians, American Medical Association, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, and International AIDS Society

Disclosure: Nothing to disclose.

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

Disclosure: Medscape Salary Employment

Aaron Glatt, MD  Professor of Clinical Medicine, New York Medical College; President and CEO, Former Chief Medical Officer, Departments of Medicine and Infectious Diseases, St Joseph Hospital (formerly 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.

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.

Additional Contributors

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Larry I Lutwick, MD, Martin Backer, MD, Sailaja Kolli, MD, and Klaus-Dieter Lessnau, MD, FCCP, to the development and writing of this article.

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