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Mycobacterium Avium Complex

MAIC


Presentation

  • Mycobacterium avium complex presenting as an endobronchial lesion in a patient post lung transplant is a novel presentation.[ncbi.nlm.nih.gov]
Splenomegaly
  • He had marked splenomegaly, hepatomegaly, and lymphadenopathy. Bone marrow aspiration was markedly hypercellular with normal myeloid to erythroid ratio, no increase in blasts, mild eosinophilia, moderate fibrosis, and focal necrosis.[bloodjournal.org]
  • Widespread involvement of the reticuloendothelial system results in hepatomegaly, splenomegaly, and lymphadenopathy, which are clinical signs that occur with statistical significance.[academic.oup.com]
  • […] palate ulcerative lesion extending from the alveolus to the palatine process of the maxilla to the palatoglossal arch The defect has a rounded edge and a small posterior area with exudates Abdomen Scaphoid, non tender 3-4 cm firm hepatomegaly but no splenomegaly[immunopaedia.org.za]
Fever
  • Recently, we encountered a case of bone marrow Mycobacterium avium complex (MAC) infection, which presented as a fever of unknown origin shortly after starting continuous ambulatory peritoneal dialysis (CAPD).[ncbi.nlm.nih.gov]
  • Signs and symptoms include bacteremia, fever, chills, fatigue, night sweats, weight loss, abdominal pain, anemia, and elevated alkaline phosphatase.[medical-dictionary.thefreedictionary.com]
Weight Loss
  • Figure 1 An 81-year-old woman was admitted with weight loss (18 kg in 27 months), hemoptysis, and tubular and diffuse granular shadows on her chest radiograph (Panel A).[doi.org]
  • The case of a Chinese boy with no medical history, who presented with diarrhea and weight loss of 14-month duration and rashes and fever or 6-month duration, is described.[ncbi.nlm.nih.gov]
  • Signs and symptoms include bacteremia, fever, chills, fatigue, night sweats, weight loss, abdominal pain, anemia, and elevated alkaline phosphatase.[medical-dictionary.thefreedictionary.com]
Fatigue
  • Signs and symptoms include bacteremia, fever, chills, fatigue, night sweats, weight loss, abdominal pain, anemia, and elevated alkaline phosphatase.[medical-dictionary.thefreedictionary.com]
  • Typical symptoms of MAC include night sweats, weight loss, fever, fatigue, diarrhea, and enlarged spleen. Antibiotics are commonly used in MAC prevention (for persons with suppressed immune systems) and treatment.[rxlist.com]
  • […] primarily affects people with compromised immune systems (for example from AIDS, hairy cell leukemia, or immunosuppressive chemotherapy) or underlying lung disease Symptoms can be non-specific and may include fever, sweats, weight loss, abdominal pain, fatigue[dovemed.com]
Anemia
  • M. vium -complex infections are a common late consequence of HIV infection, particularly in persons with low CD4 cell counts and anemia.[doi.org]
  • During follow-up, individuals who developed M. avium-complex infections were more likely to have severe anemia, to experience zidovudine dose reductions, and to die than were patients without M. avium-complex (p 0.001).[ncbi.nlm.nih.gov]
  • Signs and symptoms include bacteremia, fever, chills, fatigue, night sweats, weight loss, abdominal pain, anemia, and elevated alkaline phosphatase.[medical-dictionary.thefreedictionary.com]
Malaise
  • A 54-year-old man was admitted to our hospital because of intermittent high fever, general malaise, cough and body weight loss after he had been examined and treated at the former hospital for 3 years without a definitive diagnosis and effective therapy[ncbi.nlm.nih.gov]
  • They include fever, night sweats, anorexia and malaise, weight loss, chronic diarrhoea and non-specific abdominal pain, hepatomegaly and anaemia are common.[apps.who.int]
  • Malaise. Dyspnoea. Diarrhoea. Significant weight loss with marked wasting. Generalised lymphadenopathy Pallor. Tender hepatosplenomegaly. Cutaneous involvement. Lymphadenitis Usually affects children aged 1-4.[patient.info]
  • […] to be a significant issue in HIV disease, even in the era of HAART, EUS with core FNA is essential to rule out lymphoma and establish a correct diagnosis. 5 Case Report A 55-year-old man with a history of HIV/AIDS was admitted to our institution with malaise[acgcasereports.gi.org]
Chronic Cough
  • Pulmonary MAC infection is typically insidious, with a chronic cough usually productive of purulent sputum being most common. Hemoptysis and constitutional symptoms are not typical 2.[radiopaedia.org]
  • In 1998, she began to exhibit a chronic cough, fever and weight loss. The sputum smear was positive for acid-fast bacilli, and she started treatment for tuberculosis (TB).[scielo.br]
  • Figure 2. 83 year old lady with a chronic cough.[massgeneral.org]
Rales
  • Physical examination demonstrated persistent, coarse rales and diffuse rhonchi throughout the lungs, clubbing, and cyanosis.[doi.org]
Diarrhea
  • This case shows that Mycobacterium avium complex infection should be considered even in an immunocompetent patient with diarrhea and skin lesions.[ncbi.nlm.nih.gov]
  • Azithromycin (Zithromax, see fact sheet 530): nausea, headaches, vomiting, diarrhea; taken as capsules or intravenously. Ciprofloxacin (Cipro or Ciloxan, see fact sheet 531): nausea, vomiting, diarrhea; taken as tablets or intravenously.[aidsinfonet.org]
  • In the prospective study, DMAC was seen only in persons with a CD4 count 3 and was associated with fever ( P .03), anemia ( P .001), weight loss ( P .01), diarrhea ( P .01), and elevated alkaline phosphatase ( P .01).[doi.org]
Abdominal Pain
  • We describe a case of intestinal MAC infection in a kidney transplant recipient with 5 months of unexplained weight loss and abdominal pain who developed intestinal obstruction. Esophagoduodenoscopy with biopsies was performed but was nondiagnostic.[ncbi.nlm.nih.gov]
  • Signs and symptoms include bacteremia, fever, chills, fatigue, night sweats, weight loss, abdominal pain, anemia, and elevated alkaline phosphatase.[medical-dictionary.thefreedictionary.com]
  • They include diarrhea, abdominal pain, nausea, vomiting, and hepatosplenomegaly. 1,2 We describe a patient with disseminated MAC infection who had perforating appendicitis due to MAC. Report of a Case.[jamanetwork.com]
Chronic Diarrhea
  • diarrhea, and anemia Mycobacterium Avium Complex may cause local disease affecting the central nervous system, lymph nodes, soft tissue, or bones; or, it may cause multi-system disease also affecting other organs and systems Mycobacterium Avium Complex[dovemed.com]
  • .: Donnatal - a prescription oral adjunctive drug used in the treatment of IBS and acute enterocolitis; EnteraGam - a medical food intended for the dietary management, under medical supervision, of chronic diarrhea and loose stools and Mytesi - an anti-diarrheal[globenewswire.com]
Failure to Thrive
  • Major histocompatibility complex class II (MHCII) deficiency represents a rare form of severe immunodeficiency associated with increased susceptibility to viral, bacterial, and fungal pathogens and commonly leads to failure to thrive and early death.[ncbi.nlm.nih.gov]
Hip Pain
  • She presented with collapse of her femoral head coinciding with several months of progressive, debilitating hip pain. She had mild fevers during that time, but results from multiple infectious workups, including hip aspiration, were negative.[ncbi.nlm.nih.gov]
Night Sweats
  • Signs and symptoms include bacteremia, fever, chills, fatigue, night sweats, weight loss, abdominal pain, anemia, and elevated alkaline phosphatase.[medical-dictionary.thefreedictionary.com]
  • She denied fevers, but did endorse night sweats. She had diffuse expiratory wheezing on auscultation.[ncbi.nlm.nih.gov]
  • A 58-year-old woman presented to an outpatient clinic with painless swellings around several joints and drenching night sweats.[nejm.org]
  • Typical symptoms of MAC include night sweats, weight loss, fever, fatigue, diarrhea, and enlarged spleen. Antibiotics are commonly used in MAC prevention (for persons with suppressed immune systems) and treatment.[rxlist.com]
Cutaneous Manifestation
  • The authors present a case of disseminated MAC infection with cutaneous manifestations in an iatrogenically immunocompromised patient.[ncbi.nlm.nih.gov]
Neck Mass
  • In this report, we present the case of a 21-year-old HIV positive man, who presented with a unilateral, tender, enlarging cervical neck mass. FNAB had revealed acute inflammation.[ncbi.nlm.nih.gov]

Workup

  • This case highlights the need for an exhaustive, iterative microbiologic workup in the context of an atypical disease presentation in a renal transplant patient, regardless of the degree of immunosuppression.[ncbi.nlm.nih.gov]
  • Infectious workup was unrevealing. AFB blood cultures from initial admission grew Mycobacterium avium complex. Clarithromycin, ethambutol and rifampicin were initiated. The patient defervesced and mental status resolved to baseline within a week.[shmabstracts.com]
  • (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.com]
  • Based on a negative infectious workup, empiric antibiotics were discontinued, and the patient was discharged home to await liver biopsy results to guide further management.[ijmyco.org]
Aspergillus Niger
  • We describe a case of fatal hemoptysis from invasive Aspergillus niger infection in the setting of bullous lung disease, steroid-treated sarcoidosis, and Mycobacterium avium complex infection.[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]

Prognosis

  • CONCLUSIONS: The radiological score correlates with prognosis. The combined score of factors I, C and E may more accurately predict prognosis in MAC-LD patients.[ncbi.nlm.nih.gov]

Etiology

  • An acute inflammatory nodule of unknown etiology can pose a formidable diagnostic challenge.[ncbi.nlm.nih.gov]

Epidemiology

  • This case suggests DMAC infection in a patient without traditional epidemiological risk factors.[ncbi.nlm.nih.gov]
  • The Changing Epidemiology of Disseminated Mycobacterium avium complex in the U.S.[idsa.confex.com]
  • 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]
  • Epidemiology United States statistics NTM infections began to be reported more frequently after the incidence of tuberculosis declined in the 1950s.[emedicine.com]
Sex distribution
Age distribution

Pathophysiology

  • Animal models have been pivotal in understanding tuberculosis (TB) pathophysiology.[erj.ersjournals.com]
  • Attenuated cellular immunity associated with programmed cell death (PD)-1 may play a pathophysiological role in MAC-LD but lacks of investigation.[ncbi.nlm.nih.gov]
  • The pathophysiology of Disseminated Mycobacterium avium Complex Disease in AIDS.[immunopaedia.org.za]
  • A clear causation has not been established, however, and the pathophysiology remains largely unexplored. [5] MAI also causes cutaneous disease.[emedicine.com]

Prevention

  • 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]
  • Prevention General : Preventative therapy is usually recommended for AIDS patients who have a CD4 cell count lower than 50 cells per microliter of blood.[livingnaturally.com]

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