Pulmonary mycobacterioses. Clinical commentaries

Pulmonary mycobacterioses are diseases caused by environmental mycobacteria with chronic evolution and clinically resembling tuberculosis. We analyzed a series of 26 cases treated at the Hospital F. J. Muniz with an average age of 59.2 years, 73.1% female and 80.1% of cases belonging to medium or high socioeconomic status. Pre-existent conditions were found in 88.5% of cases (previous tuberculosis, COPD, silicoses, gastro-esophageal reflux). From the radiological point of view there were nodules, bronchiectasis, and small cavities in 14 cases and extensive cavitary bilateral lesions in 12. The higher frequency of MAC (Mycobacterium avium complex) as a pathogen is highlighted and also the better outcome of patients with lower pulmonary compromise and those affected by M. avium compared to other mycobacteria. The drugs used in the treatment were clarithromycin or azithromycin, associated to ethambutol. The overall cure rate was low (57.7%), but it was higher in cases caused by M. avium (86.7%).