Mycobacterium Xenopi Clinical Presentation

Updated: Jul 07, 2017
  • Author: Mansoor Arif, MD; Chief Editor: Mark R Wallace, MD, FACP, FIDSA  more...
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Presentation

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

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  • 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

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

Possible presenting symptoms of patients with HIV infection

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  • 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.

Varghese et al have described a patient data set in which the risk factors for M xenopi infection were pre-existing lung diseases such as emphysema. [5]

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