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Share this article Get shareable linkNontuberculous Mycobacterial (NTM) Infection Program
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Initial Evaluation
Diagnosis of NTM infections can be challenging because the symptoms can be similar to other lung diseases, like tuberculosis and lung cancer. Typically, a diagnosis is made by identifying the bacteria in a culture grown from a sputum sample (the substance that's coughed up from the lungs), but other diagnostic tests may be necessary.
Access to prior records and testing is vital to develop a timely, personalized treatment plan. Depending on how recent your previous testing is, we may also coordinate pulmonary function testing and imaging with your initial visit.
Monitoring of Disease
Monitoring nontuberculous mycobacterial (NTM) infections primarily involves clinical evaluation, imaging studies, and microbiologic cultures. By consistently monitoring the disease in these ways, our multi-disciplinary team can make informed decisions about adjusting treatment, assessing the risk of complications, and ultimately improving your health outcomes.
Treatment
Treatment for NTM infections usually involves a combination of antibiotics. The exact medications and length of treatment depend on the type of NTM causing the infection and the patient's overall health. Additional treatments may include pulmonary rehabilitation to improve lung functions. In some cases, surgery may be considered to remove the infected tissue, particularly if the infection is localized to a specific lung area.
Fifth Disease
Fifth disease, also known as erythema infectiosum, is a contagious viral illness caused by parvovirus B19. It is most common in children, but it can also affect adults. The main symptom of fifth disease is a rash that often appears on the cheeks. It can be bright red on lighter skin tones and not as noticeable on darker ones. The rash may later spread to the arms, legs, and torso. Adults may get joint pain and swelling. Most cases of fifth disease are mild, but it can sometimes cause complications in people with weakened immune systems or blood disorders.
Fifth disease got its name many years ago when it was the fifth on a list of the six recognized childhood rash-forming illnesses. The others are measles, scarlet fever, rubella, Duke's disease, and roseola.
Fifth disease symptoms appear and go away over a few weeks as you pass through the infection's three stages.
Stage 1
The first stage of fifth disease symptoms can last from seven to 14 days. They include:
Stage 2
About two to three weeks after you've been exposed to the virus, you're no longer contagious, so you can't spread the virus. If it's your child who is sick, this is when you might see a bright red rash on their cheeks, which is why some people call the infection "slapped cheek disease." The red cheeks are more common in children 10 years old or younger, and it generally lasts for five to 10 days. For people with darker skin tones, the rash might not be as noticeable.
Stage 3
At this point, if there's a rash, it will likely spread along the chest, back, arms, and legs, and the red cheeks will fade. The body rash won't look as red (or dark on dark skin) as it did on the face, though. It might look more blotchy or like lace, and the rash may be itchy but it won't hurt.
Fifth disease in adults
Fifth disease is a very common childhood disease, and once you've had the infection, you shouldn't get it again; you're immune. For this reason, not many adults get it. If you do get fifth disease as an adult, you typically won't get the rash, but you could get severe flu-like symptoms (sore muscles, coughing, etc.). About 80% of adults, mostly women, who get fifth disease get joint pain in their wrists, hands, and knees.
Fifth disease in infants
Infants can get fifth disease if they're exposed to the virus, but it usually affects children ages 5 to 15, probably because of how it can spread in schools and child care centers. Newborns may be exposed to the virus during early pregnancy, though. If this happens, they could develop severe anemia.
Fifth disease is caused by parvovirus B19. It's usually a mild infection, although very contagious. Child care centers and schools are often where children get it because they're indoors together for long periods. Some people don't get any symptoms when they get infected with parvovirus B19, so they never know they were infected.
Fifth disease is generally a mild illness that doesn't cause any serious symptoms, but it can be serious for some people who are pregnant. Although it's rare, someone who becomes infected with the virus early during a pregnancy could have a miscarriage. If you are pregnant and have reason to believe that you have or had fifth disease during the pregnancy, or you were exposed to it, speak with your doctor. They may want to monitor you and your baby more closely to check for problems. This could mean extra:
Fifth disease is spread through infected droplets in the air. When an infected person coughs or sneezes, they send these droplets into the air where you can breathe them in. These droplets can also land on hard surfaces like desktops, toys, or doorknobs, for example. When you touch these contaminated surfaces and then touch your face or nose, the virus can enter your body. If you're pregnant and you get fifth disease, it can spread through your blood to the baby. This is rare, though.
By the time the rash appears, children are no longer contagious and may attend school or day care. The incubation period (the time between infection and signs or symptoms of illness) is usually four to 14 days.
Adults who work with young children – such as child care providers, teachers, and health care workers – are most likely to be exposed.
To limit the spread of fifth disease among children at home or in a child care setting, take the following steps:
In most cases, fifth disease is diagnosed based on the appearance of typical symptoms. Although a blood test can confirm whether you have fifth disease, it's usually not necessary unless you have a problem with your immune system.
If you're pregnant and you've been exposed to fifth disease, your doctor may want you to have a blood test to determine whether you had it in the past. If you have had it before, you should be immune.
But if you do get fifth disease while you're pregnant, your doctor may recommend close monitoring. This can include having more frequent ultrasounds so your doctor can look for complications in your unborn baby, such as abnormal fluid pooling around the heart, lungs, or belly. But most of the time, fifth disease doesn't cause a baby any problems.
If an ultrasound shows there might be a problem, your doctor might want you to have either an amniocentesis or a test called cordocentesis to verify if you have the infection and, if so, how bad it is.
The goal of fifth disease treatment is to ease symptoms and make you or your child more comfortable. There's no specific medicine to treat the virus that causes fifth disease. Your doctor might suggest:
Children under 6 months shouldn't be given ibuprofen. For children younger than 6 years, ask your pediatrician before using over-the-counter cold or cough medications. Never give aspirin or products containing aspirin to a child.
Fifth disease is usually mild for otherwise healthy kids and adults and poses little risk to your health. But it can cause chronic anemia in people with sickle cell disease or a weakened immune system. You or your child could need a blood transfusion in this case, which would require a hospital stay.
You're more likely to have serious complications from fifth disease if you have a weakened immune system. Conditions that can weaken your immune system include leukemia and other cancers, HIV infection, and organ transplants.
If you get fifth disease while pregnant, there is a slight risk you could lose your baby.
You should make that call to your doctor when:
Fifth disease is a common childhood disease that most often affects children from 5 to 15 years old. This is because it's often spread in child care and school settings. Once you've had fifth disease, healthy adults can't get it again, so it's not common for adults to get it. But if you're pregnant and are exposed to fifth disease, speak with your doctor, because there is a rare risk of miscarriage.
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