Main description:

Nearly twenty years ago a symposium convened at Dallas, Texas, to con sider the place of atypical mycobacteria among agents of human disease. An edited and condensed version of that symposium was subsequently published and since that time has constituted the only bound source of infor mation covering broad aspects of mycobacterial disease. In the years since a vast amount of information has accumulated in periodical literature, some of which is not readily accessible. The time seems suitable for a comprehensive collection of this scattered material into a single book. The aim has not been to produce an exhaustive account of mycobacteria and mycobacterioses, but rather to concentrate on salient points and particularly on those most generally useful to a diverse group of interests: mycobacteriology, pathology, epidemiology, and, of course, clinical fields. In Appendix A there appear in summary form manifestations of myco bacteria as they have occurred among clinical specialities, such as ortho pedic surgery, dermatology, and urology. These summaries are designed to serve as guides to more probable infections and to lead to more extensive reading with respect to the specific organism encountered. Appendix C presents, also in summary form, drugs, regimens, duration of treatment, and toxicities to permit ready reference to less familiar anti microbial agents. These are suggestive only, useful when the general nature of the organism is known but not the specific susceptibility of the individual strain.

Contents:

I. General Characteristics.- 1. Early History of the Atypical Mycobacteria.- I. Isolations from Milk Products.- II. Isolations from the Environment.- III. Early Veterinary Mycobacteriology.- IV. Isolations from Human Material.- V. A Latent Period in Mycobacteriology.- VI. Human Infection by Avian or Avianlike Mycobacteria.- VII. Epidemiological Evidence for "Saprophytic" Infection of Humans.- VIII. Classification.- IX. Origin of the Atypical Mycobacteria.- 2. Bacteriology.- I. Cultural Characteristics.- A. Media.- B. Rate of Growth.- C. Oxygen and CO2 Requirements.- D. Temperature Requirements.- E. Hydrogen Ion Concentration.- F. Colonial Morphology and Pigmentation.- G. Cording and Orientation.- II. Biochemical Activity.- A. The Niacin Test.- B. Catelase Production.- C. Tween Hydrolysis.- D. Nitrate Reductase.- E. Amidases.- F. Arylsulfatase.- G. Reduction of Tellurite.- H. Other Biochemical Tests.- I. Mycobacterial Resistance.- J. Adansonian Classification.- III. Chemical Studies.- IV. Physical Methods.- V. Biological Methods.- A. Bacteriophage Typing.- B. Hemagglutination.- C. Precipitins.- D. Agglutinins and Agglutinin Absorption.- E. Other Methods.- 3. Epidemiology.- I. Sources in the Environment.- A. Soil.- B. Water.- II. Human Foodstuffs.- III. Mycobacteriosis of Animals.- IV. Skin Testing in Humans.- V. Serological Studies.- 4. Pathology and Pathogenesis.- I. Pulmonary Pathology.- II. Pathology of Lymph Nodes.- III. Pathology of Other Tissues.- IV. Pathogenicity for Animals.- V. Pathogenesis in Humans.- II. The Photochromogenic Mycobacteria.- 5. Mycobacterium kansasii (Hauduroy).- I. Bacteriology.- II. Pathology.- III. Epidemiology.- A. Isolations from Environmental and Nonhuman Sources.- B. Human Isolations.- 1. Geography.- 2. Age.- 3. Sex.- 4. Race.- 5. Occupational and Socioeconomic Factors.- 6. Associated Pulmonary Disease.- IV. Clinical Features.- A. "Primary" Infection of the Lung.- B. Pulmonary Disease in Adults.- 1. Symptoms.- 2. Physical Signs.- 3. Laboratory Findings.- 4. Roentgenography.- 5. Diagnosis and Differential Diagnosis.- C. Disease of the Lymph Nodes.- D. Cutaneous Disease.- E. Disease of Bone and Soft Tissue.- F. Disease of the Genitourinary System.- G. Disseminated Disease.- V. Susceptibility of M. kansasii and Treatment.- A. In Vitro Tests.- B. In Vivo Studies.- C. Results of Clinical Treatment.- 6. Mycobacterium marinum (balnei).- I. Bacteriology.- II. Epidemiology.- III. Pathology.- IV. Clinical Features.- V. Treatment.- 7. Mycobacterium simiae.- I. Bacteriology.- II. Pathology and Pathogenesis.- III. Epidemiology.- IV. Clinical Features.- V. Susceptibility and Therapy.- III. The Scotochromogenic Mycobacteria.- 8. Mycobacterium scrofulaceum.- I. Bacteriology.- II. Pathology and Pathogenesis.- III. Epidemiology.- A. Environment.- B. Secretions and Tissues of Healthy Humans.- C. Human Reactions to Sensitins.- D. Distribution of Human Disease.- 1. Geography.- 2. Age, Sex, Race, and Family.- 3. Associated Disease.- IV. Clinical Features.- A. Lymph Nodes.- B. Lung and Pleura.- C. Cutaneous Lesions.- D. Bone and Soft Tissue.- E. Disseminated Disease.- V. Susceptibility and Treatment.- A. Tests in Vitro.- B. Effects in Human Disease.- 9. Mycobacterium szulgai.- I. Bacteriology.- II. Pathology.- III. Epidemiology.- IV. Clinical Features.- V. Susceptibility and Treatment.- IV. The Nonphotochromogenic Mycobacteria.- 10. The Avium-Battey Complex.- I. Bacteriology.- II. Pathology and Pathogenesis.- III. Epidemiology.- A. Isolations from the Environment and from Food.- B. Isolations from Animals.- C. Human Isolations and Hypersensitivity.- 1. Skin Tests.- 2. Cultures from Healthy People.- 3. Epidemiology of Disease.- a. Geography.- b. Age.- c. Sex.- d. Race.- e. Occupational and Social Factors.- f. Associated Disease.- g. Familial Occurrence.- h. Other Factors.- IV. Clinical Features.- A. "Primary" Infection.- B. Pulmonary Disease in Adults.- 1. Symptoms.- 2. Physical Findings.- 3. Laboratory Findings.- 4. Roentgenographic Examination.- 5. Differential Diagnosis.- C. Disease of Lymph Nodes.- D. Cutaneous Disease.- E. Bones and Soft Tissues.- F. Genitourinary Tract.- G. Disseminated Disease.- V. Susceptibility and Treatment.- A. Tests in Vitro.- B. Trials in Vivo.- C. Experience in Human Disease.- VI. Other Group III Infections.- 11. Mycobacterium xenopi.- I. Bacteriology.- II. Pathology and Pathogenesis.- III. Epidemiology.- A. Lower Animals.- B. Environment.- C. Geography.- D. Sex.- IV. Clinical Features.- V. Susceptibility and Treatment.- V. The Rapidly Growing Mycobacteria.- 12. Mycobacterium fortuitum (with M. chelonei, M. borstelense, and M. abscessus).- I. Nomenclature.- II. Bacteriology.- III. Pathology.- A. The Lungs.- B. Skin and Subcutaneous Tissue.- C. The Cornea.- D. Other Tissues.- E. Histology.- IV. Clinical Manifestations.- A. Superficial Abscesses.- B. Pulmonary Disease.- C. Disseminated Infection.- D. Corneal Infection.- V. Treatment.- A. Subcutaneous Abscesses.- B. Pulmonary Lesions.- C. Susceptibility of M. fortuitum and Antimicrobial Therapy.- 13. Mycobacterium ulcerans.- I. Bacteriology.- II. Pathology and Pathogenesis.- III. Epidemology.- A. Geographic Distribution.- B. Age.- C. Sex.- D. Other Factors.- IV. Clinical Features.- V. Treatment.- VI. Appendix.- Appendix A. The Mycobacteria in Clinical Specialties.- Appendix B. Alternate Classifications of Atypical Mycobacteria.- Appendix C. Drugs: Dosages, Toxicities, and Combinations.- References.