Demographic data and clinical manifestations of patients with disseminated nontuberculous mycobacterial infections
| Patient . | Age, y/sex . | Onset . | Affected sites . | Pathogen(s) . | Laboratory data . | Diagnosis . | Outcome . |
|---|---|---|---|---|---|---|---|
| 1 | 55/M | 50 y | Lymph node, multiple bone sites | Mycobacterium abscessus, S enteritidis B, P marneffei | WBC:9450 (64.6/24.3/7.9/3.1/0.1), HIV (−), ANA (−), RA < 20, SSA (−), SSB (−), C3/C4:199/74.5, C-ANCA (−), P-ANCA (−), Coomb test (−), IgG/A/M: 1980/159/65.8, HBsAg (−), HCV (−), HLA-B27 (−) no chromosome abnormality, thyroid function (−) | Chronic noncaseating granulomatous lymphadenitis, osteomyelitis, Salmonella sepsis, herpes zoster | Survival with no active disease |
| 2 | 51/F | 47 y | Cervical, mediastinal, and axillary lymph nodes, multiple bone sites, skin | Mycobacterium scrofulaceum | WBC: 7390 (74.9/16.4/6.6/1.8/0.3), IgG/A/M/E: 1310/458/137/27.4, C3/C4: 203/36, ANA (−), RA < 20, HIV (−) AFP: 27.3, CEA:3.26, CA-125: 70, CA-199:3.72, normal adrenal function | Osteomyelitis, chronic cervical lymphadenitis, herpes zoster | Chronic infection under therapy |
| 3 | 69/M | 18 y | Cervical lymph node, lung, bone | Mycobacterium avium complex, S enteritidis B | WBC: 8560 (59.6/28.4/6.5/4.2/1.3), ANA (−), anti-nDNA: 1.9, RA: 88.7, C3/C4: 202/25.1, IgG/A/M/E: 2980/968/94/17.3, C-ANCA (+), P-ANCA (−), CEA: 0.46, SCC: 12.8, PSA: 1.03, HBsAg (−), HCV (−), HIV (−), normal adrenal and thyroid function | Pneumonia, lymphadenitis, osteomyelitis, Salmonella sepsis, herpes zoster | Persistent infection under therapy |
| 4 | 47/F | 44 y | Bone, cervical lymph nodes | S enteritidis D Mycobacterium gordonae | WBC: 7420 (45.5/43.8/5.9/4.4/0.4) ANA (−), C3/C4: 255/29.2, SSA/SSB (−), IgG/A/M/E: 1770/3.9/89.2/10.34, BM(−), IEP (−), PEP of blood: increase of polyclonal gamma globulin normal adrenal function | Osteomyelitis, cervical lymphadenitis, Salmonella sepsis, herpes zoster | Chronic infection under therapy |
| 5 | 55/M | 53 y | Multiple bone sites, muscles | Mycobacterium terrae | WBC: 9070 (65.8/18.4/13.1/2.4/0.3), HBsAg (−), HCV (−), C3/C4: 210/27, IgG/A/M/E: 1870/312/116/11.52, RF < 20, ANA-1:40, HIV (−), AFP: 1.7, CEA:1.93, PSA:1.037, CA19-9:15.9, SCC: 0.9 | Osteomyelitis, psoas and back muscle abscesses | Survival without active disease |
| 6 | 81/M | 81 y | Cervical and mediastinal lymph nodes, skin | Nontuberculous mycobacterium | WBC: 9730 (72.4/13.6/6.2/7.5/0.3), ANA (−), RA < 20, IgG/A/M: 1780/432/92.6, IgE:521.70, C3/C4: 131/36.1, HIV (−), AFP:2.73, CEA: 0.84, PSA: 17.899, CA199: 32, IEP: no monoclonal gammopathy, thyroid (−) | Cutaneous infection, lymphadenitis | Persistent infection under therapy |
| 7 | 66/M | 61 y | Cervical lymph nodes, lung | Nontuberculous mycobacterium | WBC: 7510 (69.7/18.8/5.9/5.5/0.1), HIV (−), RF < 20, ANA (−), Ig G/A/M-1340/367/55.6, C3/C4-115/27.2, IgE-388.91, CEA-1.22, CA199-10.2, PSA-1.23, CA125-117.9 | NTM pneumonia, cervical lymphadenitis | Survival without active disease |
| 8 | 87/M | 84 y | Multiple bone sites, skin, lymph nodes | M scrofulaceum, S aureus | WBC: 9950 (57.7/28.9/5.8/7/0.6), ANA-1:40, APF-3.61, CEA-1.72, PSA-3.14, CA199-12.8, HBV(−), HCV(−) | Osteomyelitis, lymphadenitis, pneumonia, herpes zoster, MRSA cellulitis | Survival without active disease |
| 9 | 48/M | 44 y | Bone, lung, mediastinal lymph nodes | M avium complex, S enteritidis | WBC: 7120 (54.4/29.2/4.9/10.5/1), HBsAg (−), HCV (+), AFP: 3.92 | Mycotic aneurysm, pneumonia, osteomyelitis, herpes zoster | Survival without active disease |
| 10 | 61/F | 59 y | Lymph nodes (neck, abdomen, mediastinum, retroperitoneum), skin, bone | Nontuberculous mycobacterium | WBC: 33 750 (51/9/2/25), IgG/A/M: 1550/206/108, RA < 20, C3/C4: 171/64, ANA: 1:40, AFP: 1.92, CEA: 1.44, CA-125: 9.5, CA19-9: 4.1, colonoscopy and UGI: polyps, gastritis, HIV (−), HBV(−), HCV (−) | Multiple site lymphadenopathy, osteomyelitis | Persistent infection under therapy |
| 11 | 49/M | 48 y | Lung, lymph nodes (mediastinum, neck) | Mycobacterium kansasii | WBC: 16 980 (77.9/15.6/5.1/1.2), HIV (−), colonoscopy: polyps, AFP: 1.45, CEA: 1.14, PSA: 5.671, CA19-9: 9.4; ANA: 1:40, IgG/A/M: 1990/191/182, RA < 20, C3/C4: 166/27.9 | Lymphadenitis, pneumonia, colitis, herpes zoster | Persistent infection under therapy |
| 12 | 56/F | 48 y | Bone, mediastinal lymph nodes, skin | Nontuberculous mycobacterium | WBC: 10 640 (74.7/17.1/3.8/3.3), AFP: 1.7, CEA < 0.45, SCC:0.5, IgG/A/M: 2340/639/124, RA < 20, ANA: negative, HIV (−), normal thyroid function | Osteomyelitis, erythema induratum, mediastinal lymphadenitis, herpes zoster | Persistent infection under therapy |
| 13 | 46/F | 45 y | Lung, lymph nodes | Nontuberculous mycobacterium, S enteritidis | WBC: 17 700 (81.7/7.7/9.3/1.2), CEA: 0.38, CA-124: 20.6, CA19-9:7.8, normal level of IgG/A/M | Pneumonia, neck lymphadenitis | Persistent infection under therapy |
| 14 | 72/F | 72 y | Bone (multiple sites) | M avium complex | WBC:10 750(86.2/7.6/3.2/2.5), AFP:0.79, CEA: 1.67, CA-125: 13.8, CA-153: 4.4, CA-19-9: 17.6, RA: 585, ANA (−), C3: 86.5, C4: 11.2, anti-ENA(−), Scl-70(−) IgG/A/M/E:1880/354/185/388.55, HIV(−) | Osteomyelitis (multiple sites) | Expired due to traumatic intracranial hemorrhage |
| 15 | 49/F | 47 y | Lung, lymph node, pericardium, bone | Nontuberculous mycobacterium, Legionellosis, P marneffei, | ANA(−), IgG/A/M: 2490/673/185, C3/C4: 178/36.4, RF: 22.4, ds-DNA (−), HIV(−) | Pneumonia, lymphadenitis (neck, mediastinum) | Unknown |
| 16 | 47/F | 47 y | Lung, bone, lymph nodes, skin | Nontuberculous mycobacterium, S enteritidis | WBC: 11 590(64.2/25.9/3.5/6.0), AFP: 1.43, CEA: 0.27 CA15-3: 6.8, CA-125: 6.2, CA19-9: 1.6, ANA: 1:40, RA < 20, C3/C4: 186/70.6, anti-nDNA (−), anti-microsomal antibody (−), anti-thyroglobulin antibody (−), anti-smooth muscle antibody: 1:20, C-ANCA (−), P-ANCA (−), anti-cardiolipin IgM/G: −/+, SS-A: 96.79, SS-B: 12.2, RNP: 3.1, HIV(−) | Arthritis, lymphadenitis (neck, mediastinum, abdomen, inguinal area) | Persistent infection under therapy |
| 17 | 76/M | 60 y | Lung, lymph nodes | M abscessus, M chelonae | WBC: 11 790(76.6/12.3/5.4./5.4), RA: 52.7, ANA:1:40, HIV(−), IgG/A/M: 3160/542/111, C3/C4: 84.1/31.7, AFP: 1.41, CEA: 1.14, PSA: 1.3, CA19-9: 8.7 | Lymphadenitis (neck, mediastinum, axilla) | Persistent infection under therapy |
| Patient . | Age, y/sex . | Onset . | Affected sites . | Pathogen(s) . | Laboratory data . | Diagnosis . | Outcome . |
|---|---|---|---|---|---|---|---|
| 1 | 55/M | 50 y | Lymph node, multiple bone sites | Mycobacterium abscessus, S enteritidis B, P marneffei | WBC:9450 (64.6/24.3/7.9/3.1/0.1), HIV (−), ANA (−), RA < 20, SSA (−), SSB (−), C3/C4:199/74.5, C-ANCA (−), P-ANCA (−), Coomb test (−), IgG/A/M: 1980/159/65.8, HBsAg (−), HCV (−), HLA-B27 (−) no chromosome abnormality, thyroid function (−) | Chronic noncaseating granulomatous lymphadenitis, osteomyelitis, Salmonella sepsis, herpes zoster | Survival with no active disease |
| 2 | 51/F | 47 y | Cervical, mediastinal, and axillary lymph nodes, multiple bone sites, skin | Mycobacterium scrofulaceum | WBC: 7390 (74.9/16.4/6.6/1.8/0.3), IgG/A/M/E: 1310/458/137/27.4, C3/C4: 203/36, ANA (−), RA < 20, HIV (−) AFP: 27.3, CEA:3.26, CA-125: 70, CA-199:3.72, normal adrenal function | Osteomyelitis, chronic cervical lymphadenitis, herpes zoster | Chronic infection under therapy |
| 3 | 69/M | 18 y | Cervical lymph node, lung, bone | Mycobacterium avium complex, S enteritidis B | WBC: 8560 (59.6/28.4/6.5/4.2/1.3), ANA (−), anti-nDNA: 1.9, RA: 88.7, C3/C4: 202/25.1, IgG/A/M/E: 2980/968/94/17.3, C-ANCA (+), P-ANCA (−), CEA: 0.46, SCC: 12.8, PSA: 1.03, HBsAg (−), HCV (−), HIV (−), normal adrenal and thyroid function | Pneumonia, lymphadenitis, osteomyelitis, Salmonella sepsis, herpes zoster | Persistent infection under therapy |
| 4 | 47/F | 44 y | Bone, cervical lymph nodes | S enteritidis D Mycobacterium gordonae | WBC: 7420 (45.5/43.8/5.9/4.4/0.4) ANA (−), C3/C4: 255/29.2, SSA/SSB (−), IgG/A/M/E: 1770/3.9/89.2/10.34, BM(−), IEP (−), PEP of blood: increase of polyclonal gamma globulin normal adrenal function | Osteomyelitis, cervical lymphadenitis, Salmonella sepsis, herpes zoster | Chronic infection under therapy |
| 5 | 55/M | 53 y | Multiple bone sites, muscles | Mycobacterium terrae | WBC: 9070 (65.8/18.4/13.1/2.4/0.3), HBsAg (−), HCV (−), C3/C4: 210/27, IgG/A/M/E: 1870/312/116/11.52, RF < 20, ANA-1:40, HIV (−), AFP: 1.7, CEA:1.93, PSA:1.037, CA19-9:15.9, SCC: 0.9 | Osteomyelitis, psoas and back muscle abscesses | Survival without active disease |
| 6 | 81/M | 81 y | Cervical and mediastinal lymph nodes, skin | Nontuberculous mycobacterium | WBC: 9730 (72.4/13.6/6.2/7.5/0.3), ANA (−), RA < 20, IgG/A/M: 1780/432/92.6, IgE:521.70, C3/C4: 131/36.1, HIV (−), AFP:2.73, CEA: 0.84, PSA: 17.899, CA199: 32, IEP: no monoclonal gammopathy, thyroid (−) | Cutaneous infection, lymphadenitis | Persistent infection under therapy |
| 7 | 66/M | 61 y | Cervical lymph nodes, lung | Nontuberculous mycobacterium | WBC: 7510 (69.7/18.8/5.9/5.5/0.1), HIV (−), RF < 20, ANA (−), Ig G/A/M-1340/367/55.6, C3/C4-115/27.2, IgE-388.91, CEA-1.22, CA199-10.2, PSA-1.23, CA125-117.9 | NTM pneumonia, cervical lymphadenitis | Survival without active disease |
| 8 | 87/M | 84 y | Multiple bone sites, skin, lymph nodes | M scrofulaceum, S aureus | WBC: 9950 (57.7/28.9/5.8/7/0.6), ANA-1:40, APF-3.61, CEA-1.72, PSA-3.14, CA199-12.8, HBV(−), HCV(−) | Osteomyelitis, lymphadenitis, pneumonia, herpes zoster, MRSA cellulitis | Survival without active disease |
| 9 | 48/M | 44 y | Bone, lung, mediastinal lymph nodes | M avium complex, S enteritidis | WBC: 7120 (54.4/29.2/4.9/10.5/1), HBsAg (−), HCV (+), AFP: 3.92 | Mycotic aneurysm, pneumonia, osteomyelitis, herpes zoster | Survival without active disease |
| 10 | 61/F | 59 y | Lymph nodes (neck, abdomen, mediastinum, retroperitoneum), skin, bone | Nontuberculous mycobacterium | WBC: 33 750 (51/9/2/25), IgG/A/M: 1550/206/108, RA < 20, C3/C4: 171/64, ANA: 1:40, AFP: 1.92, CEA: 1.44, CA-125: 9.5, CA19-9: 4.1, colonoscopy and UGI: polyps, gastritis, HIV (−), HBV(−), HCV (−) | Multiple site lymphadenopathy, osteomyelitis | Persistent infection under therapy |
| 11 | 49/M | 48 y | Lung, lymph nodes (mediastinum, neck) | Mycobacterium kansasii | WBC: 16 980 (77.9/15.6/5.1/1.2), HIV (−), colonoscopy: polyps, AFP: 1.45, CEA: 1.14, PSA: 5.671, CA19-9: 9.4; ANA: 1:40, IgG/A/M: 1990/191/182, RA < 20, C3/C4: 166/27.9 | Lymphadenitis, pneumonia, colitis, herpes zoster | Persistent infection under therapy |
| 12 | 56/F | 48 y | Bone, mediastinal lymph nodes, skin | Nontuberculous mycobacterium | WBC: 10 640 (74.7/17.1/3.8/3.3), AFP: 1.7, CEA < 0.45, SCC:0.5, IgG/A/M: 2340/639/124, RA < 20, ANA: negative, HIV (−), normal thyroid function | Osteomyelitis, erythema induratum, mediastinal lymphadenitis, herpes zoster | Persistent infection under therapy |
| 13 | 46/F | 45 y | Lung, lymph nodes | Nontuberculous mycobacterium, S enteritidis | WBC: 17 700 (81.7/7.7/9.3/1.2), CEA: 0.38, CA-124: 20.6, CA19-9:7.8, normal level of IgG/A/M | Pneumonia, neck lymphadenitis | Persistent infection under therapy |
| 14 | 72/F | 72 y | Bone (multiple sites) | M avium complex | WBC:10 750(86.2/7.6/3.2/2.5), AFP:0.79, CEA: 1.67, CA-125: 13.8, CA-153: 4.4, CA-19-9: 17.6, RA: 585, ANA (−), C3: 86.5, C4: 11.2, anti-ENA(−), Scl-70(−) IgG/A/M/E:1880/354/185/388.55, HIV(−) | Osteomyelitis (multiple sites) | Expired due to traumatic intracranial hemorrhage |
| 15 | 49/F | 47 y | Lung, lymph node, pericardium, bone | Nontuberculous mycobacterium, Legionellosis, P marneffei, | ANA(−), IgG/A/M: 2490/673/185, C3/C4: 178/36.4, RF: 22.4, ds-DNA (−), HIV(−) | Pneumonia, lymphadenitis (neck, mediastinum) | Unknown |
| 16 | 47/F | 47 y | Lung, bone, lymph nodes, skin | Nontuberculous mycobacterium, S enteritidis | WBC: 11 590(64.2/25.9/3.5/6.0), AFP: 1.43, CEA: 0.27 CA15-3: 6.8, CA-125: 6.2, CA19-9: 1.6, ANA: 1:40, RA < 20, C3/C4: 186/70.6, anti-nDNA (−), anti-microsomal antibody (−), anti-thyroglobulin antibody (−), anti-smooth muscle antibody: 1:20, C-ANCA (−), P-ANCA (−), anti-cardiolipin IgM/G: −/+, SS-A: 96.79, SS-B: 12.2, RNP: 3.1, HIV(−) | Arthritis, lymphadenitis (neck, mediastinum, abdomen, inguinal area) | Persistent infection under therapy |
| 17 | 76/M | 60 y | Lung, lymph nodes | M abscessus, M chelonae | WBC: 11 790(76.6/12.3/5.4./5.4), RA: 52.7, ANA:1:40, HIV(−), IgG/A/M: 3160/542/111, C3/C4: 84.1/31.7, AFP: 1.41, CEA: 1.14, PSA: 1.3, CA19-9: 8.7 | Lymphadenitis (neck, mediastinum, axilla) | Persistent infection under therapy |
AFP indicates alpha-fetoprotein; ANA, antinuclear antibody; CEA, carcinoembryonic antigen; IEP, immunoelectrophoresis; MRSA, methicillin-resistant S aureus; PSA, prostate-specific antigen; and RF, rheumatoid factor.