Nontuberculous Mycobacterial Pulmonary Disease in the Immunocompromised Host

Abstract

The immunocompromised host is at an increased risk for pulmonary and extrapulmonary NTM infections. Where data are available in these specific populations, increased mortality is observed with NTM disease. Prior to starting therapy for NTM disease, providers should ensure diagnostic criteria are met as treatment is long and often associated with significant side effects and toxicities. Treatment should involve 2 to 4 agents and be guided by cultures and antimicrobial susceptibilities. Drug interactions are important to consider, especially in those with HIV or transplant recipients. Whenever possible, immunosuppression should be reduced or changed.

Keywords: HIV; Immunocompromised host; Immunosuppressive agents; Mycobacterium infections; Nontuberculous; Nontuberculous mycobacteria; Organ transplantation; Transplant recipients.