eMedicine Specialties > Infectious Diseases > Mycobacterial Infections

Mycobacterium Xenopi: Follow-up

Author: Larry I Lutwick, MD, Professor of Medicine, State University of New York, Downstate Medical School; Director, Infectious Diseases, Veterans Affairs New York Harbor Health Care System, Brooklyn Campus
Coauthor(s): Martin Backer, MD, Fellow in Combined Adult and Pediatric Infectious Diseases, State University of New York Health Sciences Center; Sailaja Kolli, MD, Fellow, Department of Internal Medicine, Division of Pulmonary and Critical Care, The Brooklyn Hospital Center; 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
Contributor Information and Disclosures

Updated: May 12, 2009

Follow-up

Further Inpatient Care

  • Inpatient care is not necessary unless the patient is severely immunocompromised, has disseminated disease, or requires hospitalization for severity of the illness.

Further Outpatient Care

  • Monitor the patient monthly for possible adverse effects.
  • Monitoring includes (but is not limited to) the following:
    • Liver palpation and, if any discomfort, liver function testing
    • Tests for visual acuity and color vision if ethambutol is used
    • Audiometric testing if aminoglycosides are used

Inpatient & Outpatient Medications

  • Use at least 2 medications to avoid acquired resistance.
  • Intravenous administration may be required with disseminated disease.

Transfer

  • Consider referring difficult cases to a specialist center.
  • Consider sending cultures to a reference laboratory to test for susceptibility; however, routine susceptibility testing in a patient who has never been treated is not necessary.

Deterrence/Prevention

  • To date, no strategy, method, treatment, or therapy prevents M xenopi infection.

Complications

  • Chronic wasting syndrome
  • Respiratory failure
  • Chronic respiratory illness
  • Disseminated disease
  • Death

Prognosis

  • Outcome is favorable. Many people are colonized but asymptomatic.

Patient Education

  • Adverse effects of medications
  • Patient compliance with medical therapy (risk of acquired resistance if compliance is <80%)

Miscellaneous

Medicolegal Pitfalls

  • Overtreatment (of patients without true disease) may be common.
  • Rifampin and rifabutin may decrease effectiveness of oral contraceptives.
  • Ethambutol may cause amaurosis. Monitor patients monthly for visual acuity and color vision. (Ethambutol accumulates in patients with renal failure.)

Special Concerns

  • A well-documented case of M xenopi disease should be published. Many cases described in the literature are probably only examples of colonization. In such cases, overtreatment of patients without true disease may result.
 


More on Mycobacterium Xenopi

Overview: Mycobacterium Xenopi
Differential Diagnoses & Workup: Mycobacterium Xenopi
Treatment & Medication: Mycobacterium Xenopi
Follow-up: Mycobacterium Xenopi
References
Further Reading
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References

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Keywords

Mycobacterium xenopi, M xenopi, South African toad, Xenopus laevis, X laevis, nontuberculous mycobacterium, nontuberculous mycobacteria, mycobacteremia, leukocytosis, leucopenia, leukopenia, anemia, reactive thrombocytosis, thrombocytopenia, nontuberculous mycobacterial lung disease, pulmonary disease, cavitary apical pulmonary disease, multifocal bronchiectasis, granulomatous inflammation, acid-fast bacilli

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Contributor Information and Disclosures

Author

Larry I Lutwick, MD, Professor of Medicine, State University of New York, Downstate Medical School; Director, Infectious Diseases, Veterans Affairs New York Harbor Health Care System, Brooklyn Campus
Larry I Lutwick, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Coauthor(s)

Martin Backer, MD, Fellow in Combined Adult and Pediatric Infectious Diseases, State University of New York Health Sciences Center
Martin Backer, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Physicians, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Sailaja Kolli, MD, Fellow, Department of Internal Medicine, Division of Pulmonary and Critical Care, The Brooklyn Hospital Center
Sailaja Kolli, MD is a member of the following medical societies: American Medical Association
Disclosure: Nothing to disclose.

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

Medical Editor

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.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

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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