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Mycobacterium Avium


Presentation

  • To present the case of an ear infection with Mycobacterium avium in the absence of demonstrable immunosuppression. Clinical case description, blood tests, routine histology and tissue cultures.[ncbi.nlm.nih.gov]
  • The authors present the clinical, laboratory and pathologic findings in 2 patients who presented with hypercalcemia and normal vitamin D metabolites with no other ready explanation for the hypercalcemia.[ncbi.nlm.nih.gov]
  • We report a case of a 33-year-old woman where MAI presented as an endobronchial tumour due to IRIS. She responded well to standard anti-MAI treatment (rifamycins, macrolide and ethambutol).[ncbi.nlm.nih.gov]
  • We present a case of acute empyema with intractable pneumothorax associated with ruptured lung abscess caused by Mycobacterium avium in an immunocompromised patient.[ncbi.nlm.nih.gov]
  • A 63-year-old woman presented with a fever, eruption, and sterile pyuria.[ncbi.nlm.nih.gov]
Metal Worker
  • METHODS: Custom-quantitative PCR assays, microscopy and phylogenetic analyses were performed on blinded MWF samples to quantify microbial burden and identify potential aetiological agents of HP in metal workers.[ncbi.nlm.nih.gov]
Fracture
  • Apart from pulmonary disease, compressive fractures of the 12th thoracic and 1-4th lumbar vertebrae were detected.[ncbi.nlm.nih.gov]
Dermatitis
  • Bilateral swelling of his optic nerves and facial dermatitis improved after initiating anti-mycobacterial chemotherapy.[ncbi.nlm.nih.gov]

Workup

  • NTM infection should be added to the list of pathogens in sickle cell patients with CVCs and fever and should be considered in frequent pRBC transfusion like reaction with negative workup.[bloodjournal.org]
  • Blood workup revealed normal ionogram, C-reactive protein 80 g/dl, leukocytes 11 430 mm 3 (90% neutrophils and 1.4% eosinophils), hemoglobin 12.4 g/dl, hematocrits 36.4%, platelets 309 000 mm 3 .[archbronconeumol.org]
  • (See Workup.) In general, MAC infection is treated with 2 or 3 antimicrobials for at least 12 months. Commonly used first-line drugs include macrolides (clarithromycin or azithromycin), ethambutol, and rifamycins (rifampin, rifabutin).[emedicine.medscape.com]
Pericardial Effusion
  • Abstract We report the case of a 36-year-old man who had acquired immune deficiency syndrome and developed suppurative mediastinitis extending over the left lung and anterior thoracic wall around the sternum, pericardial effusions, splenomegaly, and mesenteric[ncbi.nlm.nih.gov]
Pyuria
  • A 63-year-old woman presented with a fever, eruption, and sterile pyuria.[ncbi.nlm.nih.gov]
Hypercapnia
  • An analysis of 17 environmental isolates revealed that hypoxia (5% oxygen) preferentially enhanced pellicle formation both in plastic plates and in glass tubes, compared with hypercapnia (5% carbon dioxide).[ncbi.nlm.nih.gov]

Treatment

  • After 12 months of treatment, 42 (74%) patients had a favorable response to treatment, whereas 15 (26%) patients had an unfavorable response to treatment defined as the absence of sputum culture conversion within 12 months of treatment.[ncbi.nlm.nih.gov]
  • treatment after bacilli negative conversion.[ncbi.nlm.nih.gov]
  • Treatment outcomes were poor after the development of macrolide resistance, with favorable treatment outcomes achieved in only five (15%) patients, including two patients who underwent surgical resection.[ncbi.nlm.nih.gov]
  • There was significant heterogeneity of microbial effect among treatment regimens (I2   40%; P   0.001).[ncbi.nlm.nih.gov]
  • Objectives: To develop a thioridazine/moxifloxacin-based combination regimen for treatment of pulmonary infection due to Mycobacterium avium-intracellulare complex (MAC) that kills bacteria faster than the standard treatment regimen.[ncbi.nlm.nih.gov]

Prognosis

  • Prognosis depends on the form of the disease. In the upper lobe cavitary form, lung destruction is usually progressive and can lead to respiratory failure and death if successful treatment is not instituted.[radiopaedia.org]
  • Focal nodular disease has the best prognosis and tends to be fairly benign.[patient.info]
  • A worse prognosis was noted with male sex, comorbidities (e.g. coexisting lung disease) and the presence of fibrocavitary disease.[bmcinfectdis.biomedcentral.com]
  • Prognosis The prognosis of untreated MAC infection therapy is poor.[hivmanagement.ashm.org.au]
  • Prognosis Prior to the availability of newer macrolides, the life expectancy of a patient with AIDS and DMAC infection was 4 months.[emedicine.medscape.com]

Etiology

  • M. intracellulare was the etiologic organism in 21 (62%) patients.[ncbi.nlm.nih.gov]
  • The etiologic organisms included M. avium in 32 (56%) patients and M. intracellulare in 25 (44%) patients. Seven (12%) patients had the fibrocavitary form of the disease on computed tomography.[ncbi.nlm.nih.gov]
  • Abstract Bovine leukemia virus (BLV) is a retrovirus that causes enzootic bovine leukosis in cattle, and Mycobacterium avium subsp. paratuberculosis (MAP) is the etiologic agent of Johne's disease in cattle.[ncbi.nlm.nih.gov]
  • Abstract Mycobacterium avium ssp. paratuberculosis is the etiologic agent of Johne's disease in ruminants and is hypothesized to be an infectious cause of Crohn's disease, as well as some other human diseases.[ncbi.nlm.nih.gov]
  • The etiologic agent was M. avium in 77 patients (48.7%) and M. intracellulare in 81 patients (51.3%).[aac.asm.org]

Epidemiology

  • BACKGROUND: Although the incidence rates of non-tuberculous mycobacteria (NTM) have been increasing in many countries, the basic epidemiology of NTM remains to be fully understood.[ncbi.nlm.nih.gov]
  • Based on our review, we suggest two sets of modifications for epidemiologic and clinical studies.[journals.plos.org]
  • Fecha de publicación: 05 - 2017 Editorial: Cambridge University Press Revista: Epidemiology and Infection Idioma: Inglés Citación: Imperiale, Belén Rocío; Moyano, Roberto Damian; Di Giulio, A.[ri.conicet.gov.ar]
  • Molecular epidemiology and genetic characterization in the present study showed the distinctive genetic evolutionary lineage of MAH strains isolated from human pMAC diseases and swine.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • Animal models have been pivotal in understanding tuberculosis (TB) pathophysiology.[erj.ersjournals.com]
  • Childhood lymphadenitis due to MAC is very rare but appears to be on the increase in developed countries. [ 3 ] Pathophysiology M. avium causes 95% of AIDS-related MAC infections. [ 4 ] M. intracellulare causes 40% of MAC infections in the immunocompetent[patient.info]
  • A clear causation has not been established, however, and the pathophysiology remains largely unexplored. [5] MAI also causes cutaneous disease.[emedicine.medscape.com]

Prevention

  • Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine and Grady Memorial Hospital, and Division of HIV/AIDS, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, US Department[academic.oup.com]
  • However, MAC disease is preventable. One of the best ways to prevent it is to avoid CD4 counts from dropping below 100 by starting potent HIV treatment. In people whose CD4 counts do not respond adequately, preventive drugs are taken.[poz.com]
  • Prevention It is not possible to avoid being exposed to the bacteria that cause MAC. The best way to prevent developing the disease is to keep your immune system strong and your CD4 count well above 50.[catie.ca]

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