Revisão narrativa: pericardite por micobactéria não tuberculosa

Abstract

Non-tuberculous mycobacteria (NTM) refer to species of mycobacteria other than Mycobacterium tuberculosis and M. leprae. These microorganisms are ubiquitous in the environment, found in domestic water, natural water sources, and soil. Although NTM infections typically result from airborne transmission, they are not transmitted from person to person like tuberculosis. Fecal-oral transmission is also a common route, especially in children. The main NTM species of clinical importance include M. avium complex, M. abscessus complex, and M. kansasii. NTM-related diseases present in four primary syndromes: chronic pulmonary disease, lymphadenitis, cutaneous disease, and disseminated disease. Chronic pulmonary disease is the most common clinical manifestation, typically caused by slow-growing NTMs. However, in immunocompromised individuals, such as transplant recipients or HIV-infected patients, the disease can present atypically with abdominal, hematological, or pericardial involvement. NTM-induced pericarditis is a rare but increasingly recognized complication, especially in immunocompromised or chronically ill populations. This narrative review examines the relationship between NTM infections and pericarditis. A search in the PUBMED database revealed only four studies on this subject, highlighting its rarity. The review discusses the various forms of pericarditis, including acute, effusive-constrictive, and chronic pericarditis, and how NTM can lead to severe pericardial conditions like cardiac tamponade. Case studies demonstrate the challenges of diagnosing and treating NTM- related pericarditis, particularly in immunocompetent individuals. Therapeutic strategies often involve a combination of antimicrobials and, in severe cases, surgical interventions like pericardiectomy. In conclusion, while pericardial involvement by NTM is rare, it poses significant diagnostic and therapeutic challenges. Prompt recognition and an interdisciplinary treatment approach are crucial for managing this condition, especially in patients with underlying immunological conditions or chronic infections.