Hospital Sultanah Nur Zahirah,Terengganu, Malaysia
Non-Tuberculous Mycobacterium (NTM) are ubiquitous, free living, environmental saprophytic organisms known to occupy water systems, soil and vegetation. It has potential to colonize and eventually infect either immunocompromised or immunocompetent individuals. NTM are found worldwide and the prevalence are increasing in the last three decades. NTM infections is easily missed, difficult to diagnose and difficult to treat.
Four distinct clinical syndromes associated with NTM infection has been described in children: skin and soft tissue disease, lymphadenitis, pulmonary disease and disseminated disease. It causes a spectrum of clinical disease ranging from asymptomatic to severe symptomatic infection.
Diagnosis of NTM disease requires clinical, radiological and microbiological assessment. Culture in both liquid and solid media is the gold standard for NTM diagnosis, however NTM growth usually takes 42 to 56 days in liquid and solid medium. Polymerase chain reaction (PCR), is the most sensitive and rapid test to detect NTM infection.
The treatment of NTM infection is challenging. Depending on the context of presentation and site of infection, three overlapping management options for NTM infections are long courses of anti-mycobacterial antibiotics, surgical excision of infected tissue or removal of indwelling foreign bodies and ‘watchful wait’.