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

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, Mycobacterium avium 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.

Instituto de Biotecnología

Fil: Echeverria, Gustavo. Universidad Central del Ecuador. Instituto de Investigación en Zoonosis-CIZ; Ecuador

Fil: Echeverria, Gustavo. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Programa de Doctorado; Argentina

Fil: Echeverria, Gustavo. BioGENA. División Investigación y Desarrollo; Ecuador

Fil: Rueda, Veronica. Universidad Central del Ecuador. Instituto de Investigación en Zoonosis-CIZ; Ecuador

Fil: Espinoza, Wilson. Hospital de Especialidades Eugenio Espejo. Departamento de Tuberculosis; Ecuador

Fil: Rosero, Carlos. Hospital de Especialidades Eugenio Espejo. Departamento de Tuberculosis; Ecuador

Fil: Zumarraga, Martin Jose. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Agrobiotecnología y Biología Molecular; Argentina

Fil: Zumarraga, Martin Jose. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina

Fil: Waard, Jacobus H. de. Universidad Central de Venezuela. Instituto de Biomedicina “Jacinto Convit”. Departamento de Tuberculosis; Venezuela

Fil: Waard, Jacobus H. de. Universidad de Las Américas. Facultad de Ciencias de la Salud. One Health Research Group; Ecuador