Skip to main content

Advertisement

Log in

The spectrum of tuberculosis and non-tuberculous mycobacterial infection

  • Chest
  • Published:
European Radiology Supplements

Abstract

The spectrum of radiographic findings in pulmonary infections due to M. tuberculosis (TB) and non-tuberculous mycobacteria (NTM) are being increasingly discussed, primarily as a result of the increasing prevalence of these infections. The NTM organisms are often overlooked as potential infecting organisms, diagnosis is often delayed and radiologists tend not to include NTM in their differential diagnosis. The literature on the imaging appearances of NTM pulmonary infections is now sufficiently large as to identify some features that would help to distinguish an NTM infection from conventional pulmonary tuberculosis, allowing the radiologist at least to raise the possibility of NTM infection. This review article is intended to describe the radiological features, in the immunocompetent host, that accompany TB and NTM pulmonary infections and highlight the imaging features that would favour an NTM as the causative organism.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1.
Fig. 2.
Fig. 3.
Fig. 4.
Fig. 5.
Fig. 6.
Fig. 7.
Fig. 8.
Fig. 9.
Fig. 10.
Fig. 11.
Fig. 12.
Fig. 13.
Fig. 14.
Fig. 15.

Similar content being viewed by others

References

  1. Runyon EH (1959) Anonymous mycobacteria in pulmonary disease. Med Clin North Am 43:273–291

    CAS  Google Scholar 

  2. Albelda SM, Kern JA, Marinelli DL, Miller WT (1985) Expanding spectrum of pulmonary disease caused by nontuberculous mycobacteria. Radiology 157:289–296

    CAS  PubMed  Google Scholar 

  3. O’Brien R (1989) The epidemiology of nontuberculous mycobacterial disease. Clin Chest Med 10:407–418

    PubMed  Google Scholar 

  4. Miller WTJ, Miller WTS (1993) Pulmonary infections with atypical mycobacteria in the normal host. Semin Roentgenol 28:139–149

    PubMed  Google Scholar 

  5. Woodring JH, Vandiviere HM (1990) Pulmonary disease caused by nontuberculous mycobacteria. J Thorac Imaging 5:64–76

    PubMed  Google Scholar 

  6. Fraser RS, Paré PD, Müller NL, Colman N (1999) Mycobacteria. In: Fraser RS, Paré PD, Müller NL, Colman N (eds) Diagnosis of diseases of the chest, 4th edn. Saunders, Philadelphia, pp 798–873

  7. Goo JM, Im JG (2002) CT of tuberculosis and nontuberculous mycobacterial infections. Radiol Clin North Am 40:73–87

    Google Scholar 

  8. Leung AN, Muller NL, Pineda PR, Fitzgerald JM (1992) Primary tuberculosis in childhood: radiographic manifestations. Radiology 182:87–91

    CAS  PubMed  Google Scholar 

  9. Palmer PE (1979) Pulmonary tuberculosis: usual and unusual radiographic presentations. Semin Roentgenol 14:204–243

    CAS  PubMed  Google Scholar 

  10. Contreras MA, Cheung OT, Sanders DE, Goldstein RS (1988) Pulmonary infection with nontuberculous mycobacteria. Am Rev Respir Dis 137:149–152

    PubMed  Google Scholar 

  11. Swensen SJ, Hartman TE, Williams DE (1994) Computed tomographic diagnosis of mycobacterium avium-intracellulare complex in patients with bronchiectasis. Chest 105:49–52

    PubMed  Google Scholar 

  12. Leung AN, Brauner MW, Gamsu G, Mlika-Cabanne N, Ben-Romdhane H, Carette MF, Grenier P (1996) Pulmonary tuberculosis: comparison of CT findings in HIV-seropositive and HIV-seronegative patients. Radiology 198:687–691

    CAS  PubMed  Google Scholar 

  13. Hidaka E, Honda T, Ueno I, Yamasaki Y, Kubo K, Katsuyama T (2000) Sensitive identification of mycobacterial species using PCR-RFLP on bronchial washings. Am J Respir Crit Care Med 161:930–934

    CAS  PubMed  Google Scholar 

  14. Obayashi Y, Fujita J, Suemitsu I, Kamei T, Nii M, Takahara J (1998) Clinical features of non-tuberculous mycobacterial disease: comparisons between smear-positive and smear-negative cases, and between mycobacterium avium and mycobacterium intracellulare. Int J Tuberc Lung Dis 2:597–602

    CAS  PubMed  Google Scholar 

  15. Wallace RJJ, O’Brien R, Glassroth J, Raleigh J, Dutt A (1990) Diagnosis and treatment of disease caused by nontuberculous mycobacteria. Am Rev Respir Dis 142:940–953

    PubMed  Google Scholar 

  16. Choyke PL, Sostman HD, Curtis AM, Ravin CE, Chen JT, Godwin JD, Putman CE (1983) Adult-onset pulmonary tuberculosis. Radiology 148:357–362

    CAS  PubMed  Google Scholar 

  17. Lee KS, Im JG (1995) CT in adults with tuberculosis of the chest: characteristic findings and role in management. Am J Roentgenol 164:1361–1367

    Google Scholar 

  18. Lee KS, Song KS, Lim TH, Kim PN, Kim IY, Lee BH (1993) Adult-onset pulmonary tuberculosis: findings on chest radiographs and CT scans. Am J Roentgenol 160:753–758

    CAS  Google Scholar 

  19. Im JG, Song KS, Kang HS, Park JH, Yeon KM, Han MC, Kim CW (1987) Mediastinal tuberculous lymphadenitis: CT manifestations. Radiology 164:115–119

    CAS  PubMed  Google Scholar 

  20. Kim WS, Moon WK, Kim IO, Lee HJ, Im JG, Yeon KM, Han MC (1997) Pulmonary tuberculosis in children: evaluation with CT. Am J Roentgenol 168:1005–1009

    CAS  Google Scholar 

  21. Choyke PL, Sostman HD, Curtis AM, Ravin CE, Chen JT, Godwin JD, Putman CE (1983) Adult-onset pulmonary tuberculosis. Radiology 148:357–362

    CAS  PubMed  Google Scholar 

  22. Woodring JH, Vandiviere HM, Fried AM, Dillon ML, Williams TD, Melvin IG (1986) Update: the radiographic features of pulmonary tuberculosis. Am J Roentgenol 146:497–506

    CAS  Google Scholar 

  23. McAdams HP, Erasmus J, Winter JA (1995) Radiologic manifestations of pulmonary tuberculosis. Radiol Clin North Am 33:655–678

    CAS  PubMed  Google Scholar 

  24. Molina M, Ortega N, Valiente B, Vera V (2001) Spontaneous pneumothorax and active pulmonary tuberculosis. Ann Med Interna 18:149–151

    CAS  Google Scholar 

  25. Kim HY, Song KS, Goo JM, Lee JS, Lee KS, Lim TH (2001) Thoracic sequelae and complications of tuberculosis. Radiographics 21:839–858

    CAS  PubMed  Google Scholar 

  26. Christensen EE, Dietz GW, Ahn CH, Chapman JS, Murry RC, Hurst GA (1978) Radiographic manifestations of pulmonary Mycobacterium kansasii infections. Am J Roentgenol 131:985–993

    CAS  Google Scholar 

  27. Lynch DA, Simone PM, Fox MA, Bucher BL, Heinig MJ (1995) CT features of pulmonary Mycobacterium avium complex infection. J Comput Assist Tomogr 19:353–360

    PubMed  Google Scholar 

  28. Hartman TE, Swenson SJ, Williams DE (1993) Mycobacterium avium-intracellulare complex: evaluation with CT. Radiology 187:23–26

    PubMed  Google Scholar 

  29. Bailey WC (1983) Treatment of atypical mycobacterial disease. Chest 84:625–628

    CAS  PubMed  Google Scholar 

  30. Varghese G, Shepherd R, Watt P (1988) Fatal infection with Mycobacterium fortuitum associated with oesophageal achalasia. Thorax 43:151–152

    PubMed  Google Scholar 

  31. Aronchick JM, Miller WT, Epstein D (1986) Association of achalasia and pulmonary mycobacterium fortuitum infection. Radiology 160:85–86

    PubMed  Google Scholar 

  32. Laissey J-P, Cadi M, Cinqualbe A, Boudiaf ZE, Lariven S, Casalino E, Wolff M, Schouman-Claeys E (1997) Mycobacterium tuberculosis vs nontuberculous mycobacterial infection of the lung in AIDS patients: CT and HRCT patterns. J Comput Assist Tomogr 21:312–317

    Article  PubMed  Google Scholar 

  33. Moon WK, Im JG, Yeon KM, Han MC (1997) Tuberculosis of the central airways: CT findings of active and fibrotic disease. Am J Roentgenol 169:649–653

    CAS  Google Scholar 

  34. Choe KO, Jeong HJ, Sohn HY (1990) Tuberculous bronchial stenosis: CT findings in 28 cases. Am J Roentgenol 155:971–976

    Google Scholar 

  35. Kim Y, Lee KS, Yoon JH, Chung MP, Kim H, Kwon OJ, Rhee CH, Han YC (1997) Tuberculosis of the trachea and main bronchi: CT findings in 17 patients. Am J Roentgenol 168:1051–1056

    Google Scholar 

  36. Moore EH (1993) Atypical mycobacterial infection in the lung: CT appearance. Radiology 187:777–782

    PubMed  Google Scholar 

  37. Primack SL, Logan PM, Hartman TE, Lee KS, Müller NL (1995) Pulmonary tuberculosis and Mycobacterium avium-intracellulare: a comparison of CT findings. Radiology 194:413–417

    PubMed  Google Scholar 

  38. Obayashi Y, Fujita J, Suemitsu I, Kamei T, Nii M, Takahara J (1999) Successive follow-up of computed tomography in patients with Mycobacterium avium-intracellulare complex. Respir Med 93:11–15

    PubMed  Google Scholar 

  39. Kubo K, Yamazaki Y, Masebuchi T, Takamizawa A, Yamamoto H, Koizumi T, Fujimoto K, Matzusawa Y, Honda T, Hasegawa M, Sone S (1998) Pulmonary infection with mycobacterium avium-intracellulare leads to air trapping distal to the small airways. Am J Respir Crit Care Med 158:979–984

    PubMed  Google Scholar 

  40. Evans AJ, Crisp AJ, Hubbard RB, Colville A, Evans SA, Johnston IDA (1996) Pulmonary Mycobacterium kansasii infection: comparison of radiological appearances with pulmonary tuberculosis. Thorax 51:1243–1247

    PubMed  Google Scholar 

  41. Im JG, Itoh H, Shim YS, Lee JH, Ahn J, Han MC, Noma S (1993) Pulmonary tuberculosis: CT findings—early active disease and sequential change with antituberculous therapy. Radiology 186:653–660

    CAS  PubMed  Google Scholar 

  42. Ellis SM, Hansell DM (2002) Imaging of non-tuberculous (atypical) mycobacterial pumlonary infection. Clin Radiol 57:661–669

    Google Scholar 

  43. Eckburg PB, Buadu EO, Stark P, Sarinas PS, Chitkara RK, Kuschner WG (2000) Clinical and chest radiographic findings among persons with sputum culture positive for mycobacterium gordonae. Chest 117:96–102

    Article  CAS  PubMed  Google Scholar 

  44. Evans AJ, Crisp AJ, Colville A, Evans SA, Johnston IDA (1993) Pulmonary infections caused by Mycobacterium malmoense and Mycobacterium tuberculosis: comparison of radiographic features. Am J Roentgenol 161:733–737

    CAS  Google Scholar 

  45. Reich JM, Johnson RE (1991) Mycobacterium avium complex pulmonary disease: incidence, presentation, and response to therapy in a community setting. Am Rev Respir Dis 143:1381–1385

    CAS  PubMed  Google Scholar 

  46. Anderson DH, Grech P, Townshend RH, Jephcott AE (1975) Pulmonary lesions due to opportunistic mycobacteria (review includes 30 cases of M. kansasii infections). Clin Radiol 26:461–469

    CAS  PubMed  Google Scholar 

  47. Hazelton TR, Newell JDJ, Cook JL, Huitt GA, Lynch DA (2000) CT findings in 14 patients with mycobacterium chelonae pulmonary infection. Am J Roentgenol 175:413–416

    CAS  Google Scholar 

  48. Smith MJ, Citron KM (1983) Clinical review of pulmonary disease caused by Mycobacterium xenopi. Thorax 38:373–377

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to S. M. Ellis.

Additional information

ECR 2004 - Categorical Course “Infection in the adult today”

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ellis, S.M. The spectrum of tuberculosis and non-tuberculous mycobacterial infection. Eur Radiol Suppl 14, E34–E42 (2004). https://doi.org/10.1007/s00330-003-2042-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-003-2042-1

Keywords

Navigation