Once the decision to treat has been made, it is critical to define adequate therapy. Seven of our HIV-positive patients who received antituberculosis therapy survived, and none of those who died received antituberculosis therapy. Nevertheless, we cannot definitively prove that they died because of M gordonae disease, and not because of an additional infection (see…
Patient 12 had 1 positive sputum sample, but 5 blood cultures with centrifugation lysis, 12 sputa, the bronchoalveolar lavage, and the bone marrow aspiration and biopsy specimen did not reveal M gordonae. All these diagnostic procedures may expose the patient to potential complications. On the other hand, empirical treatment may induce unwanted side effects such…
Classic criteria for pathogenicity of MOTTs are major criteria with (1) repeated isolation (> than 4 episodes) of colonies in large numbers (>100) with clinical symptoms or (2) positive cultures with histopathologic changes. Minor criteria are (1) repeated discharge or large numbers of organisms, (2) positive cultures of secretions with clinical symptoms, (3) positive cultures…
Mycobacterium gordonae has been called tap water bacillus or M aquae and is commonly found in soil (gardeners may have a higher risk), nonpasteurized fresh milk, and water. In humans it can be found in sputum, gastric fluid, and urine as a saprophyte or colonizer. Nosocomial outbreaks (tap water, ice machine, bronchoscopies, laboratory contamination) have…
Small cavitary lesions were seen in three patients, and lymphadenopathy was seen on CXR in one patient and on gallium scan in three patients. No patient had extrapulmonary disease alone. There was no evident correlation of our patients in regard to ward and time of hospitalization. This also included water supplies, ice machines, inhalation therapy,…
We found two HIV-positive patients with dissemination (patients 1 and 2): one had mycobacteremia with one positive blood culture and one had positive cultures of a bone marrow aspirate, a synovial fluid aspirate, and three positive sputa with repeatedly high colony counts. The latter had evident signs of mycobacterial disease with hilar, mediastinal, and abdominal…
We evaluated 15 HIV-negative patients with respiratory secretions positive for M gordonae; no patient had active disease attributable to the organism and therefore specific treatment was not given. The nine radiographic abnormalities could be explained by the underlying disease. Patients 7 and 8 had been treated with medication with potential antituberculosis activity; but the underlying…
Specimens were inoculated on lowenstein-Jensen cultures and Middlebrook 7H11 medium and since February 1990, specimens were also cultured in Bactec 12B vials (Becton Dickinson and Company, Towson, Md). Colonies of Л/ gordonae were smooth and yellow pigmented. Acid-fast bacilli (AFB) stains were done on submission of the specimens, colon) counts were performed to estimate quantity…
This is a retrospective ease-control study in a 499-bed medical center with an AIDS-designated unit of 51 beds and additional AIDS patients on other floors. In the period covered by this survey, we had more than 100 HIV-positive patients with definitive Л/ tuberculosis disease.s Thus, missed tuberculosis that could account for the clinical symptoms is…
Mycobacterium gordonae, named after the American bacteriologist Ruth E. Gordon, also called M aquae or the tap water bacillus, belongs to the group of mycobacteria other than tuberculosis (MOTT). It is classified in Runyon group 2 as a scotochromogenic organism. Within the MOTT group it is one of the least pathogenic organisms; it is slowly…
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