see also:

• clinically important bacteria
• Wikipedia

• includes M. tuberculosis, M. bovis, and others
• see tuberculosis (TB)

• the main organism responsible for leprosy (Hansen's disease).
• It was discovered in 1873 by the Norwegian physician Gerhard Armauer Hansen, who was searching for the bacteria in the skin nodules of patients with leprosy. It was the first bacterium to be identified as causing disease in humans.
• Leprosy is not highly infectious, as approximately 95% of people are immune and sufferers are no longer infectious after only a couple of days on treatment.
• Effective treatment for leprosy appeared in the late 1930s with the introduction of dapsone and its derivatives.
• The search for more effective anti-leprosy drugs than dapsone led to the use of clofazimine and rifampicin in the 1960s and 1970s.
• two to three million people are estimated to be permanently disabled because of Leprosy. India has the greatest number of cases, with Brazil second and Burma third.
• Brazil, Madagascar, Mozambique, Tanzania and Nepal as having 90% of new cases.

• formerly Mycobacterium Avium Intracellulare Scrofulaceum (MAIS) and consists of M. avium and M. intracellulare
• these are ubiquitous and can be found in:
  • aerosolized water (fresh water or salt water, especially hot water systems which have had temperature lowered)
  • house dust
  • soil, birds, ruminant farm animals (esp. deer)
  • cigarette components (tobacco, filters, paper)
• apparently, there is no human-to-human transmission
• presents in 3 forms:
  • unilateral chronic cervical lymphadenopathy/lymphadenitis in children
  • disseminated disease with diarrhoeal illness in patients with HIV / AIDS with low CD4 counts who have not been treated with highly active antiretroviral therapy.
  • pulmonary MAC infection in immunocompetent hosts
    • non-TB mycobacteria (NTM) such as M. avium, M. abscessus, M. lentiflavum, M fortuitum and M. kansasii can be spread by water supplies, particularly if hot water system temperatures have been lowered to save energy costs
    • Lady Windermere syndrome:
      • mainly thin, healthy, middle aged or elderly women who tend to avoid expectorating sputum to reduce the bacterial load, and who may have thoracic skeletal abnormalities such as pectus excavatum, scoliosis, straight back, or mitral valve prolapse.
      • chronic infection, mainly of the R. middle or L. lingula lobes, and chronic cough, leading to bronchiectasis over period of months-years
    • fibrocavity form:
      • mainly older patients, esp. males, with PH smoking and underlying chronic obstructive pulmonary disease (COPD) or bronchiectasis
    • hot tub lung disease:
      • mainly young and middle aged who frequently use poorly maintained indoor hot tubs
      • diffuse interstitial and nodular infiltrates mimicking hypersensitivity pneumonitis
    • in 2014, it was found that of the 200 cases per year in Brisbane, 40% were due to the water supply
  • less common presentations:
    • skin or soft tissue infections - usually following penetration of skin by a foreign body
    • osteomyelitis
    • peritonitis in those with cirrhosis
    • bursitis
    • septic arthritis
    • tenosynovitis
  • these cases require Rx with 2 or 3 anti-mycobacterial drugs for 12 - 18 months

• see Buruli ulcer / Bairnsdale ulcer