First Case Reports of Nontuberculous Mycobacterial (NTM) Lung Disease in Ecuador: Important Lessons to Learn

• Published in: Pathogens (Basel) Vol. 12; no. 4; p. 507
• Main Authors: Echeverria, Gustavo, Rueda, Veronica, Espinoza, Wilson, Rosero, Carlos, Zumárraga, Martín J, de Waard, Jacobus H
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 23.03.2023; MDPI
• Subjects: Bronchopulmonary infection; Case Report; Case reports; Case studies; Control programs; Culture; Cystic fibrosis; Disease control; Ecuador; HIV; Hospitals; Human immunodeficiency virus; Infections; Laboratories; Lung diseases; MAC infection; Medical records; Microscopy; Morphology; Mycobacterial infections; nontuberculous mycobacteria (NTM); Patients; Public health; pulmonary infection; Sputum; Tuberculosis; Ecuador; United States > US; nontuberculous mycobacteria (NTM); Ecuador; pulmonary infection; MAC infection; tuberculosis
• ISSN: 2076-0817; 2076-0817
• DOI: 10.3390/pathogens12040507

Nontuberculous mycobacteria (NTM) lung infections are often misdiagnosed as tuberculosis, which can lead to ineffective antibiotic treatments. In this report, we present three cases of NTM lung infections in Ecuador that were initially diagnosed and treated as tuberculosis based on the results of sputum smear microscopy. The patients, all male, included two immunocompetent individuals and one HIV-positive subject. Unfortunately, sputum culture was not initiated until late in the course of the disease and the cause of the lung infection, complex (MAC), was only identified after the patients had either passed away or were lost to follow-up. These cases are the first documented cases of NTM lung infections in the English medical literature from Ecuador. We emphasize the importance of accurate diagnosis of NTM infections by culture and identification to species level. Sputum smear staining alone cannot differentiate between mycobacterial species, which can lead to misidentification and ineffective treatments. Additionally, reporting NTM pulmonary disease as a notifiable disease to national TB control programs is recommended to obtain accurate prevalence data. These data are critical in determining the importance of this public health problem and the necessary actions needed to address it.