CLINICAL FEATURES OF NONTUBERCULOUS MYCOBACTERIAL DISEASE - COMPARISONS BETWEEN SMEAR-POSITIVE AND SMEAR-NEGATIVE CASES, AND BETWEEN MYCOBACTERIUM-AVIUM AND MYCOBACTERIUM-INTRACELLULARE

OBJECTIVE: To evaluate the differences in clinical symptoms and radiol ogical findings between smear-positive non-tuberculous mycobacteria (N TM) and smear-negative, culture-positive NTM. Also, to evaluate the di fferences in clinical symptoms and radiological findings between Mycob acterium avium and M. intracellulare. DESIGN: A retrospective study wa s performed of 200 cases with positive pulmonary cultures for NTM betw een January 1989 and December 1996. It was determined whether or not p ulmonary disease was caused by NTM using the 1990 criteria recommended by the American Thoracic Society. Clinical symptoms and radiological findings were compared between groups. RESULTS: Fever and hemoptysis w ere more frequently observed in smear-positive patients (26/50, 52%, a nd 24/50, 48%, respectively) than in smear-negative, culture-positive patients (8/38, 21.1%, P < 0.005, 8/38, 21.1%, P < 0.01, respectively) . In addition, cavity formation was more frequently observed in chest computed tomography scans of smear-positive patients (19/36, 52.8%) th an in smear-negative patients (6/31, 19.4%, P < 0.005). Finally, cavit y formation tended to be more frequently observed with M. avium than w ith M, intracellulare, CONCLUSION: The present study demonstrates diff erences in clinical symptoms and radiological findings between smear-p ositive and smear-negative NTM cases, as well as between M. avium and M. intracellulare.