Diseases Resembling Tuberculosis

Many types of mycobacteria exist; many can cause infections that produce symptoms similar to tuberculosis.

The most common are a group known as Mycobacterium avrium complex (MAC). Although these mycobacteria are common, they generally cause infection only in people with a weakened immune system or with lungs that have been damaged by prolonged smoking, an old tuberculosis infection, bronchitis, emphysema, or other diseases. Similar to tuberculosis, a MAC infection primarily affects the lungs but may also attack the lymphnodes, bones, skin, and other tissues. Unlike tuberculosis, a MAC infection cannot be passed from one person to another.

The infection usually develops slowly. The first symptoms include coughing and spitting up nucus. As the infection progresses, the person may regularly spit up blood and have trouble breathing. A chest X-ray may or may not reveal an infection. A laboratory analysis of sputum taken from an infected person is needed to distinguish the infection from tuberculosis.

In people with AIDS or other diseases that weaken the immune system, MAC infection can spread throughout the body. Symptoms include a fever, anemia, blood disorders, diarrhoea, and stomach pain.

MAC infection of the lymph nodes may develop in children, generally those between the ages of 1 and 5 years. The infection is usually caused by eating soil or drinking water that is contaminated with the mycobacteria. Antibiotics do not usually cure the infection, but the infected lymph nodes can be removed by surgery.

MAC infections were very difficult to treat until recently, because the bacteria were resistant to most of the antibiotics effective against tuberculosis. Newer antibiotics, such as clarithromycin and azithromcin - which do not work in tuberculosis - have been found to be effective against MAC when used in combination with ethambutol and rifabutin.

Other mycobacteria grow in swimming pools and even in home aquariums and can cause skin disorders. These infections may clear up without treatment. However, people with chronic infections usually need treatment with tetracycline, clarithromycin, or another antibiotic for 3 to 6 months. Another type of mycobacteria, Mycobacterium fortuitum, can infect wounds and aftificial body parts, such as a mechanical heart valve or breast implant. Antibiotics and surgical removal of the infected areas usually cure the infection.

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