1.0 Abstract
Pulmonary Mycobacterium avium complex (MAC) infection may represent the next major health concern for immunocompromised patients; however the exact pathogenesis remains largely unknown. Current therapy consists of combined antibiotic treatment but bacterial eradication is frequently unsuccessful and the appearance of macrolide-resistant non-tuberculous mycobacteria (NTM) strains is cause for concern. In other mycobacterial disease such as tuberculosis (TB), infected mononuclear cells secrete soluble factors capable of driving unopposed secretion of proteolytic enzymes from stromal cells, which appears to be a causative factor for matrix degradation and progressive cavitary lung disease. As the pathophysiology of pulmonary MAC
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The route of transmission for MAC is via inhalation or ingestion; thus this complex is capable of causing pulmonary or gastrointestinal disease, which frequently becomes disseminated systemically (6). Due to their presence in the environment, MAC infections are relatively common, yet rarely pathogenic (5).
2.2 Epidemiology
Pulmonary NTM disease is an emerging infection with increasing incidence and morbidity, occurring mainly in areas with decreasing prevalence of TB (1, 7-9). This changing epidemiology may be attributed to an increasing prevalence of the susceptible host; as the survival of ‘at-risk’ patient groups is increasing, owing to improvements in medical health care. A previous lack of accurate diagnosis due to unawareness of NTM disease may also be attributed to this trend, and finally, a potential decrease in cross-protective herd immunity due to reduced exposure to TB and/or the dimished use of Bacillus Calmette–Guérin (BCG) vaccination may r contributing factors (1, 10).
Patients at risk of developing a MAC-associated lung disease are those with pre-existing pulmonary conditions, such as chronic obstructive pulmonary disease (COPD), bronchiectasis or cystic fibrosis, or those with systemic immunosuppression, such as human immunodeficiency virus (HIV) infection, cancer, inherited immune disorders, or those taking immunosuppressive drugs (1, 5,
Tuberculosis is caused by the bacteria “Mycobacterium Tuberculosis” and is mainly causes infection of the lungs (WHO, 2016). Its mode of transmission is airborne, so it can be passed on by inhalation of airborne droplets which carrying the bacteria, when an infected patient coughs, sneezes, or spits the TB germs into the air (WHO, 1026). Among the symptoms of active TB are: cough with sputum and blood, chest pains, weakness, fever and night sweats (WHO, 2016). Most at risk to get the TB infection are people with weakened immune system such as people who are suffering from chronic diseases such as diabetes mellitus, severe kidney disease, silicosis and especially HIV infection (CDC, 2016). Children and Tobacco users are also at greater risk to fall ill with TB.
Tuberculosis is a disease of an infectious nature caused by a bacterium known as mycobacterium tuberculosis. The disease spreads through the air. People with the disease can spread it to susceptible people through coughing, sneezing, talking or spitting. It mainly affects the lungs and other parts such as the lymph nodes and kidneys can also be affected. The symptoms for TB are fatigue, coughing, night sweats, weight loss and fever. One third of the population of the world is affected with mycobacterium tuberculosis. The rate of infection is estimated to be one person per second. About 14 million people in the world are infected with active tuberculosis. Drug resistant TB has been recorded to be a serious public health hazard in many countries. Resistant strains have developed making it difficult to treat the disease. TB has caused millions of death mainly in people living with HIV/AIDS ADDIN EN.CITE Ginsberg19981447(Ginsberg, 1998)1447144717Ginsberg, Ann M.The Tuberculosis Epidemic: Scientific Challenges and OpportunitiesPublic Health Reports (1974-)Public Health Reports (1974-)128-13611321998Association of Schools of Public Health00333549http://www.jstor.org/stable/4598234( HYPERLINK l "_ENREF_3" o "Ginsberg, 1998 #1447" Ginsberg, 1998). The World Health Organization came up with the DOTS (Directly Observed, Therapy, Short course) strategy. The approach involves diagnosing cases and treating patients with drugs for about 6-8
The transmission of this infection is known to be passed from one individual to another by the faecal – oral route.
TB is an unevenly spread disease due to structural violence and cultural arrangements present in today’s society. These unnatural causes create a social and medical barrier that makes TB more
Chronic bronchitis, the fourth leading cause of death in the United States, is a main component of Chronic Obstructive Pulmonary Disease (COPD) that is characterized by airflow limitation that is irreversible. Clinically chronic bronchitis is defined as prolonged inflammation of the bronchi and bronchioles that leads to insistent coughing and overproduction of mucus recurrently for at least three months per year, two years in a row (Mannino, 2002). Inflammation decreases the diameter of both the bronchi and bronchioles and consequently makes breathing much more challenging. Smoking is the number one risk factor of chronic bronchitis. According to the
This paper aims to explore the etiology, epidemiology, pathophysiology and the treatment of Bronchiectasis. This disease continues to affect various conditions that tend to affect and even cause damage to the lungs. For this paper, we will also present a variety of research studies, which will show statistics of this condition, and how it is being treated to reduce its effects among patients.
According to the World Health Organization, tuberculosis (TB) is the number two killer worldwide due to a single infectious agent (WHO, 2017). In 2015, 10.4 million new cases have been identified and 1.8 million people have died from this disease (WHO, 2017). TB is caused by the bacteria Mycobacterium TB, and the majority of TB deaths occur in low and middle-income countries. This disease is curable and preventable, but the lack of access to proper healthcare and medication administration makes it a concern for the most of the world’s population. TB is an airborne disease that can transmit when an infected person coughs, sneezes, spits, laughs, or talks. The majority of TB cases can be cured when the right medications are available and
Mycobacterium Avium Complex (MAC) is an atypical Mycobacterium associated with human disease that affects people who have an underlying lung disease, such as tuberculosis and who are immune compromised, such as AIDS, hairy cell leukemia or immunosuppressive chemotherapy. Mac has been associated with infection of the bone (osteomyelitis), inflammation of the sheath that covers the tendons (tenosynovitis), inflammation of the synovial membrane (synovitis), and disseminated disease involving the lymph nodes, the central nervous system, the liver, spleen and bone marrow. Mycobacterium Avium Complex is the most common cause of infection by nontuberculous mycobacteria or NTM in patients with AIDS. MAC rarely occurs
Smoking: Smoking causes bronchoconstriction, sluggish ciliary movement, increases airway resistance, hypertrophy of the mucous glands, increased number of goblet cells and hypersecretion of mucus. Though smoking is said to be the most important cause, yet only 10%-15% of the smokers develop COPD. Usually a cigarette smoking history of greater than 20 pack Years is associated with the disease. (1 pack year is equivalent to smoking 20 cigarettes
This study included a total of two hundred (n=200) clinical samples from 100 immunocompromised patients (43 men, 57 women; average age 16-90 years) as 70 Bronchoalveolar lavage (BAL), 21sputum samples and 9 pleural fluids, with underlying diseases; 22 leukemia,17solid tumor, 15 lymphomas, 12 chronic pulmonary obstruction disease(CPOD), 10 asthma(steroid therapy) 10 rheumatoid arthritis(cytotoxic therapy), 8 solid-organ transplantation and 6 Multiple myeloma with clinical suspicion of pneumocystosis (Appendix-A). Control group included 100 samples( 50 Bronchoalveolar lavage (BAL), 30 sputum samples and 20 pleural fluids) from immunocompetent individuals were collected from of in-and out patients
Mycoplasma pneumoniae is an atypical bacterium that may result in lung infection by causing damage in the lining of the respiratory tract.
Mycobacterium tuberculosis is a pathogen, which its physiology is directly linked to features of tuberculosis that it causes. The crucial feature for a mycobacteria’s survival is its unique cell wall structure. The insoluble cell wall core of MTB is formed by a large variety of lipid-containing molecules, such as mycolic acid, that are covalently attached (6). This hydrophobic cell wall provides a physical protection from the host immune response and serves as a barrier against many toxic insults (2). Further, the complex MTB cell wall is impermeable to both hydrophobic and hydrophilic molecules, resulting in inherent resistance of MTB to most common antibiotics (8). Lipoarabinomannan is an antigen on the outside of the organism. This antigen is another important component of the cell wall because it inhibit the fusion of Mycobacterium-containing phagosomes with lysosomal compartments (4). Lipoarabinomannan hinders the fusion of phagosome with lysosome by impairing Ca2+/calmodulin pathway and inactivates macrophages (8). Therefore, this cell-surface component of MTB is able to facilitate the survival of mycrobacteria within macrophages (8). Also, MTB is able to survive the harsh environment of the host tissues by utilizing any available
Pneumonias are respiratory infections that lead to inflammation of the lung structures such as the alveoli and the bronchioles (Porth, 2011). It is also a significant cause of morbidity and mortality among all age groups. The very young, the very old or those with chronic disease are more susceptible to the disease. According to Driver (2012), “1.4 million people die each year because of pneumonia.” Pneumonias are categorized based on where the infection is acquired, types of organisms that cause the infection, and the location of the lung that infection occurs. The presence of signs and symptoms depends on types of pneumonia and hosts’ defense mechanisms and is the result of the destruction of the alveoli and impairment of gas exchange.
characterized by the airflow obstruction that could be caused by either chronic bronchitis or emphysema or by both conditions (Lewis, 2013). This airflow- obstruction may gradually progress to partially reversible COPD condition (GOLD, 2010). If a COPD patient is exposed to any of the risk factors as cigarette smoking, respiratory infection, etc and even though if he is in effective collaborative management, acute exacerbations of COPD may occur leading to life threatening circumstances. In regard to Mr. Bill McDonald who is a 65 years old man and known case of COPD
Tuberculosis is among the fatal diseases that are spread through the air. It’s contagious, meaning that it spreads from one infected individual to another, and at times it spreads very fast. In addition to being contagious, the disease is an opportunist infection as it takes advantage of those with weak defense mechanism, and especially the ones with terminal diseases like HIV and AIDS. Tuberculosis is therefore among the major concerns for the World Health Organization due to its contagious nature (World Health Organization 1).