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LETTER TO EDITOR |
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| Year : 2010 | Volume
: 5
| Issue : 1 | Page : 55 |
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| Mendelian susceptibility to mycobacterial infection should be ruled out in Mycobacterium chelonae empyema |
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Luis Ignacio Gonzalez-Granado
Immunodeficiencies Unit, Hospital 12 Octubre, Carretera Andalucia km 5,400, Madrid, Spain
| Date of Web Publication | 15-Jan-2010 |
Correspondence Address:
Luis Ignacio Gonzalez-Granado
Immunodeficiencies Unit, Hospital 12 Octubre, Carretera Andalucia km 5,400, Madrid
Spain
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1817-1737.58964
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How to cite this article:
Gonzalez-Granado L. Mendelian susceptibility to mycobacterial infection should be ruled out in Mycobacterium chelonae empyema. Ann Thorac Med 2010;5:55 |
Sir,
I am grateful to Wali S [1] for his contribution to the knowledge of nontuberculous mycobacterial infections. [1] Nevertheless, I would like to make one comment - When assessing immunocompetence, we need to ask ourselves what are we looking for. It is well known that patients with deficiency of interferon gamma1/2R-IL12/R-IL23/R pathway (also known as Mendelian susceptibility to mycobacterial disease (MSMD) are prone to non tuberculous mycobacterial infections. Patients with defects in the interferon gamma pathway are predisposed to mycobacterial diseases, while those with defects in the IL-12 pathway are frequently threatened by nontyphoid (systemic) salmonellosis. Tuberculosis has been described in both of these signaling pathway defects. These disorders are genetically different but immunologically similar as impaired IFNg-mediated immunity is the common pathogenic mechanism accounting for mycobacterial infection in all patients. The severity of the histological and clinical phenotype depends on the type of genetic defect. Genetic dissection of the IFNgamma/IL-12/IL23 pathway has improved our understanding of the human immune response to mycobacteria in the last ten years and help us to elucidate the genetic bases of tuberculosis. [2],[3] This assessment has not been done in any of the two cases of M. chelonae empyema reported, [4] and it could elucidate the immunocompromissed status against mycobacterial infections.
 References | |  |
| 1. | Wali S. Mycobacterium chelonae empyema with bronchopleural fistula in an immunocompetent patient. Ann Thorac Med 2009;4:213-5.  [PUBMED]  |
| 2. | Remus N, Reichenbach J, Picard C, Rietschel C, Wood P, Lammas D, et al. Impaired interferon gamma-mediated immunity and susceptibility to mycobacterial infection in childhood. Pediatr Res 2001;50:8-13. [PUBMED] [FULLTEXT] |
| 3. | Altare F, Jouanguy E, Lamhamedi S, Döffinger R, Fischer A, Casanova JL. Mendelian susceptibility to mycobacterial infection in man. Curr Opin Immunol 1998;10:413-7. |
| 4. | Hsieh HC, Lu PL, Chen TC, Chang K, Chen YH. Mycobacterium empyema in an immunocompetent patient. J Med Microbiol 2008;57:664-7 [PUBMED] [FULLTEXT] |
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