A woman's long-term cough and blood coughing are actually related to her bathing habits! Doctor: Many people are negligent!

Ms. Li (pseudonym), 39, has been controlling her diet to maintain her figure. She has a slim figure and poor immunity, and has been suffering from recurrent coughs for three or four years. Although the cough is not severe, she coughs up some yellow-white sputum every time, and sometimes there is blood in the sputum. After visiting many hospitals, she was diagnosed with bronchiectasis and bacterial infection. Although anti-infection and anti-inflammatory treatment can temporarily relieve the symptoms, they will recur when the weather changes.

"I have been coughing, coughing up phlegm and coughing up blood for a long time. Could I have tuberculosis?" Ms. Li came to Zhejiang Provincial Hospital of Integrated Traditional Chinese and Western Medicine (Hangzhou Red Cross Hospital) on the recommendation of a friend. After carefully examining her chest CT images, the attending physician Chen Yuanyuan concluded that Ms. Li did not have tuberculosis, but nontuberculous mycobacterium pulmonary disease (NTM pulmonary disease).

After further testing of sputum samples, it was identified as an infection with non-tuberculous mycobacteria - avian Mycobacterium. The culprit for the cough and hemoptysis that had plagued Ms. Li for many years was finally found.

Director Chen's daily clinic

Looking at the test results in her hand, Ms. Li was confused: "Director Chen, I don't come into contact with birds, how could I be infected with this bacteria?"

Director Chen told her that in fact, Mycobacterium avium is widely present in the natural environment of water and soil. It is a conditionally pathogenic bacterium and people with poor immune function are easily infected.

Mycobacterium avium is naturally resistant to many antibiotics and anti-tuberculosis drugs and requires combined treatment with multiple antibiotics.

After two months of combined antibiotic treatment, Ms. Li's cough and hemoptysis improved, the lung lesions were more absorbed than before, and the sputum mycobacterium culture also turned negative. She continued the consolidation treatment for another year before stopping the medication.

But less than a year later, Ms. Li started coughing again and her sputum contained blood. She came to the expert clinic of Associate Chief Physician Chen Yuanyuan again, and underwent a review of chest CT, sputum mycobacterium rapid culture and bacterial species identification. She was diagnosed with a recurrence of nontuberculous mycobacterium pulmonary disease (NTM lung disease), still with Mycobacterium avium.

"I have persisted in treatment for a year, why did it relapse again?" Ms. Li was in tears as she looked at the test results.

After carefully inquiring about Ms. Li's living habits, Dr. Chen keenly grasped a detail. Because Ms. Li was afraid of cold and catching a cold, she liked to turn on the hot water before taking a shower and wait for the hot water mist to fill the bathroom before entering the bathroom to shower. At the same time, her shower head had not been replaced for more than ten years. It was this living habit that caused Ms. Li to be repeatedly infected with avian Mycobacterium!

Authoritative research shows that Mycobacterium avium is a type of avian intracellulare Mycobacterium complex (MAC), which can grow in water without the addition of additional nutrients, and can also grow at temperatures of 15°C-45°C and salinity of 0%-2% sodium chloride (NaCl). Therefore, it can exist for a long time in the pipes of the urban water supply system. In addition, the dark and humid environment of the shower head that has not been replaced for a long time makes the aerosols produced during hot showers contain more MAC. If inhaled by immunocompromised patients, it will lead to lung colonization and disease.

Based on the drug sensitivity results of Mycobacterium avium isolated from Ms. Li's sputum, Associate Chief Physician Chen Yuanyuan customized an individualized combination of Chinese and Western medicine treatment plan for her. In addition to combined antibiotic treatment, Chinese medicine was also added to regulate the spleen and stomach and replenish lung qi to enhance her own immunity.

After two months of treatment, Ms. Li no longer had coughing and coughing up blood, and the lesions in her lungs were significantly absorbed. She also replaced the shower head at home and changed her bathing habits, mainly taking a bath in a tub to reduce the inhalation of aerosols.

Dr. Chen reminds that although non-tuberculous mycobacterial lung disease is not as common as tuberculosis, it is a health threat that cannot be ignored for susceptible populations.

People with weakened immune systems must pay attention to the small details of bathing in their daily lives, change shower heads regularly, reduce shower time or switch to tub baths, reduce the inhalation of aerosols containing microorganisms such as NTM, and reduce the chance of infection.