ABSTRACT
STUDY OBJECTIVES: To describe the clinical and radiographic findings associated with growth of Mycobacterium gordonae in cultured sputum and to determine the proportion of cases that fulfill criteria for nontuberculous mycobacterial pulmonary disease as established by the American Thoracic Society. DESIGN: A retrospective review of charts and radiographs of all patients from whom M gordonae was isolated from sputum cultures between November 1996 and June 1998. SETTING: University-affiliated Veterans Affairs hospital. PATIENTS: Nineteen patients were identified with sputum culture positive for M gordonae. All patients had a chest radiograph within 1 month of sputum culture. RESULTS: Sixteen patients (84%) had suppressed local and/or general immunity. Sixteen patients (84%) had respiratory symptoms, weight loss, fever, or night sweats as an indication for chest radiography. Seventeen patients (89%) had abnormal chest radiographs; however, no typical radiographic pattern was observed. No patient met diagnostic criteria for nontuberculous mycobacterial pulmonary disease as delineated by the American Thoracic Society. All patients with abnormal chest radiographs and/or respiratory symptoms ultimately had alternative explanations for their pulmonary disease. CONCLUSIONS: There is a broad spectrum of chest radiographic findings among persons with sputum culture positive for M gordonae, arguing against the presence of a characteristic chest radiograph in this patient population. M gordonae is usually a nonpathogenic colonizing organism, even among persons with local or general immune suppression and abnormal chest radiograph findings.
Subject(s)
Mycobacterium Infections, Nontuberculous/diagnostic imaging , Nontuberculous Mycobacteria/isolation & purification , Pneumonia, Bacterial/diagnostic imaging , Radiography, Thoracic , Sputum/microbiology , Adult , Aged , Aged, 80 and over , Biopsy , Colony Count, Microbial , Diagnosis, Differential , Humans , Male , Middle Aged , Mycobacterium Infections, Nontuberculous/microbiology , Mycobacterium Infections, Nontuberculous/pathology , Nontuberculous Mycobacteria/growth & development , Pneumonia, Bacterial/microbiology , Pneumonia, Bacterial/pathology , Retrospective StudiesABSTRACT
Positron emission tomography imaging is useful for the characterization of the solitary pulmonary nodule and mediastinal staging. Potential future applications include extrathoracic staging to help to determine the ideal site for possible tissue diagnosis, to guide treatment plans, and to monitor the response to therapy and recurrence. Positron emission tomography may also predict prognosis. This review discusses the uses of positron emission tomography, the current literature, and the clinical guidelines for positron emission tomography imaging.