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2.1
Mycobacterium Avium Complex
MAIC

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WIKIDATA, CC BY 3.0

Presentation

The present retrospective study contains selection bias, as some patients were only followed by chest radiogram and not HRCT. In addition, the proportion of patients excluded from the present study is relatively high. [erj.ersjournals.com]

This is known as Lady Windermere syndrome. [ 6 ] MAC can also present as a hypersensitivity pneumonitis. [patient.info]

Mycobacterium avium complex presenting as an endobronchial lesion in a patient post lung transplant is a novel presentation. [ncbi.nlm.nih.gov]

Case Presentation: A 58 year‐old male with recently diagnosed HIV presented with altered mental status in setting of six months progressive cognitive decline, visual hallucinations and paranoia. [shmabstracts.com]

Immune System

  • Splenomegaly

    […] productive cough dyspnoea weight loss fatigue fever lymphadenopathy immunocompromised hot tub use More key diagnostic factors Other diagnostic factors age under 5 years middle-to-old age night sweats abdominal pain diarrhoea ronchi/crackles hepatomegaly splenomegaly [bestpractice.bmj.com]

    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]

    These histopathologic findings manifest radiologically as hepatomegaly and/or splenomegaly. Additionally, focal hypoattenuating areas may be identified in the liver and/or spleen that correspond to the granulomas. [pubs.rsna.org]

Entire Body System

  • 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]

    Discussion: Symptoms of disseminated mycobacterium avium complex (MAC) infection are non‐specific, including fever, diarrhea, and weight loss. Early diagnosis and treatment are challenging. [shmabstracts.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. [medicinenet.com]

    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

    Weight loss. Nonspecific focal chest signs: crackles, wheeze, bronchial breathing, dullness to percussion. Clubbing (in cases with underlying bronchiectasis). [patient.info]

    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. [medicinenet.com]

    Signs and symptoms include bacteremia, fever, chills, fatigue, night sweats, weight loss, abdominal pain, anemia, and elevated alkaline phosphatase. [medical-dictionary.thefreedictionary.com]

    Last reviewed: 28 Feb 2023 Last updated: 04 May 2021 Summary Mycobacterium avium complex (MAC) has variable presenting features including chronic cough, weight loss, and fevers. [bestpractice.bmj.com]

  • Fatigue

    CONTINUE SCROLLING OR CLICK HERE FOR RELATED SLIDESHOW SLIDESHOW The 14 Most Common Causes of Fatigue See Slideshow [medicinenet.com]

    Signs and symptoms include bacteremia, fever, chills, fatigue, night sweats, weight loss, abdominal pain, anemia, and elevated alkaline phosphatase. [medical-dictionary.thefreedictionary.com]

    Fatigue is divided into the experience of fatigue (frequency, duration, and intensity) and the impact of fatigue on physical, mental, and social activities. [clinicaltrials.gov]

    These can include: Cough Weight loss Fever Fatigue Night sweats Symptoms of disseminated mycobacterium avium complex infections can include: Fever Sweating Fatigue Weight Loss Diarrhea Shortness of breath Abdominal pain Anemia Other, less common symptoms [everydayhealth.com]

  • Anemia

    M. vium -complex infections are a common late consequence of HIV infection, particularly in persons with low CD4 cell counts and anemia. [atsjournals.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]

  • Chills

    Signs and symptoms include bacteremia, fever, chills, fatigue, night sweats, weight loss, abdominal pain, anemia, and elevated alkaline phosphatase. [medical-dictionary.thefreedictionary.com]

    He reported generalized weakness, fever, chills, night sweats, decreased appetite and weight loss. His laboratory data were significant for thrombocytosis of 992,000/uL, mild anemia, and a normal white blood cell count of 10,000/uL. [bloodjournal.org]

    […] doi: 10.1097/IPC.0000000000000463 Case Report Abstract In Brief Author Information Authors Article Metrics Metrics A 64-year-old white female presented with 4 years of episodic, productive cough, fevers, chills, night sweats, and weight loss. [journals.lww.com]

    The symptoms of MAC can include high fevers, chills, diarrhea, weight loss, stomach aches, fatigue, and anemia (low numbers of red blood cells). [aidsinfonet.org]

Respiratoric

  • Sputum

    In total, 54 patients had a positive sputum sample on smear with at least two positive sputum samples on culture. The remaining five patients had at least three positive sputum samples on culture with a negative sputum sample on smear. [erj.ersjournals.com]

    Baseline semiquantitative sputum culture scores did not differ between patients with sputum conversion and those without. [ncbi.nlm.nih.gov]

    Lanes 6 and 7, Isolates from shower water and a sputum sample from patient 34. Lanes 8 and 9, Isolates from bathtub water and a sputum sample from patient 29. Lanes 10 and 11, Isolates from shower water and a sputum sample from patient 19. [cid.oxfordjournals.org]

    After 11 patients converted a sputum culture of MAC, 9 (81.8%) had a positive Aspergillus sputum culture ( tables 6 and 9 ). [bmjopenrespres.bmj.com]

  • Chronic Cough

    Figure 2. 83 year old lady with a chronic cough. [massgeneral.org]

    Last reviewed: 28 Feb 2023 Last updated: 04 May 2021 Summary Mycobacterium avium complex (MAC) has variable presenting features including chronic cough, weight loss, and fevers. [bestpractice.bmj.com]

    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]

    Fatigue Chronic cough Shortness of breath Treatment for mycobacterium avium complex lung disease (MAC) If you are diagnosed with MAC lung disease, you will work with your doctor to make decisions about your treatment options. [uthealtheasttexas.com]

  • Rales

    Physical examination demonstrated persistent, coarse rales and diffuse rhonchi throughout the lungs, clubbing, and cyanosis. [doi.org]

Gastrointestinal

  • 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]

    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. [medicinenet.com]

    This patient presented with abdominal pain and distension, anorexia, diarrhea, and cough. [hindawi.com]

  • Abdominal Pain

    Signs and symptoms include bacteremia, fever, chills, fatigue, night sweats, weight loss, abdominal pain, anemia, and elevated alkaline phosphatase. [medical-dictionary.thefreedictionary.com]

    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]

    This patient presented with abdominal pain and distension, anorexia, diarrhea, and cough. [hindawi.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]

    C. diff. affects the digestive system and causes severe, chronic diarrhea. It can be life-threatening. Severe MAC lung disease can affect your ability to do the things you once loved. As a result, you may develop depression or anxiety. [my.clevelandclinic.org]

    diarrhea and loose stools and Mytesi ® - an anti-diarrheal drug indicated for the symptomatic relief of non-infectious diarrhea in adult patients with HIV/AIDS on anti-retroviral therapy. [globenewswire.com]

  • Abdominal Tenderness

    Physical examination revealed an axillar temperature of 36.6°C (rectal temperature, 38°C), mild abdominal distention with hepatosplenomegaly, absence of bowel sounds, diffuse abdominal tenderness, and a positive psoas sign. [jamanetwork.com]

    At physical examination, the patient was cachectic, with normal vital signs and mild diffuse abdominal tenderness. [pubs.rsna.org]

  • Regurgitation

    Systolic murmurs of mitral regurgitation and tricuspid regurgitation may be present in patients with ventricular enlargement. Sudden cardiac death due to a fatal arrhythmia is sometimes the presenting feature. [merckmanuals.com]

    Patients with myocarditis usually present with signs and symptoms of acute decompensation of heart failure (eg, tachycardia, gallop, mitral regurgitation, edema) and, in those with concomitant pericarditis, with pericardial friction rub. [emedicine.medscape.com]

    When it comes to LV EMB, one of the main concerns is potential severe mitral regurgitation due to biopsied chordae, so fluoroscopy can also help to prevent this situation. [revespcardiol.org]

Musculoskeletal

  • Musculoskeletal Pain

    Other side effects in Arikayce-treated patients were dysphonia, cough, ototoxicity, upper airway irritation, musculoskeletal pain, fatigue/asthenia, diarrhea, and nausea. [empr.com]

    Other common side effects in patients taking Arikayce were dysphonia (difficulty speaking), cough, ototoxicity (damaged hearing), upper airway irritation, musculoskeletal pain, fatigue, diarrhea and nausea. [infectioncontroltoday.com]

Skin

  • Night Sweats

    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. [medicinenet.com]

    Signs and symptoms include bacteremia, fever, chills, fatigue, night sweats, weight loss, abdominal pain, anemia, and elevated alkaline phosphatase. [medical-dictionary.thefreedictionary.com]

    A 58-year-old woman presented to an outpatient clinic with painless swellings around several joints and drenching night sweats. [nejm.org]

    She denied fevers, but did endorse night sweats. She had diffuse expiratory wheezing on auscultation. [ncbi.nlm.nih.gov]

Neurologic

  • Asthenia

    Other side effects in Arikayce-treated patients were dysphonia, cough, ototoxicity, upper airway irritation, musculoskeletal pain, fatigue/asthenia, diarrhea, and nausea. [empr.com]

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]

Workup for human immunodeficiency virus, other viruses, and fungal infections were negative (Table). Fiberoptic bronchoscopy was unremarkable. Bone marrow biopsy was done for pancytopenia which showed hypocelleular marrow and multiple granulomas. [amjmed.com]

(See Etiology, Clinical, and Workup.) [emedicine.medscape.com]

Serum

  • CD4 Lymphocytes Decreased

    We then gated CD4 and CD8 in CD3-positive lymphocytes and further gated CD25 in CD4-positive lymphocytes. [nature.com]

Microbiology

  • Streptococcus Pneumoniae

    In addition, Enterobacter spp. (5.9%), Haemophilus influenza (4.5%), Acinetobacter baumannii (3.2%) and Streptococcus pneumoniae (2.7%) were isolated with lower frequencies in the progressive group, and Streptococcus pneumoniae (7.1%), Haemophilus influenzae [erj.ersjournals.com]

Treatment

Of the 42 patients, 22 (52%) had a history of antituberculosis treatment. Antibiotic treatment The median duration of treatment was 18 months (IQR, 13 to 22). [kjim.org]

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]

Combination treatment with at least two drugs is essential. [bestpractice.bmj.com]

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]

Focal nodular disease has the best prognosis and tends to be fairly benign. [patient.info]

Little is known regarding the prognosis of untreated stable MAC-LD. [erj.ersjournals.com]

Etiology

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

In an attempt to elucidate the etiology of DMAC infection, several theories were considered. [ijmyco.org]

Epidemiology

This case suggests DMAC infection in a patient without traditional epidemiological risk factors. [ncbi.nlm.nih.gov]

Epidemiology of human pulmonary infection with nontuberculous myco-bacteria: a review. Clin Chest Med 2015; 36:13–34 [Google Scholar] 3. [ajronline.org]

Nontuberculous mycobacteria epidemiology and the impact on pulmonary and cardiac disease. Thorac Surg Clin 2019;29:59-64. 10. Prevots DR, Marras TK. Epidemiology of human pulmonary infection with nontuberculous mycobacteria. [acarindex.com]

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]

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.. J Infect Dis, 179 (1999), pp. S461--5 [2.] Lefkowitch JH.. Pathology of AIDS-Related Liver Disease.. Dig Dis, 12 (1994), pp. 321--30 [3.] [elsevier.es]

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]

Prevention

Antibiotics are commonly used in MAC prevention (for persons with suppressed immune systems) and treatment. CONTINUE SCROLLING OR CLICK HERE FOR RELATED SLIDESHOW SLIDESHOW The 14 Most Common Causes of Fatigue See Slideshow [medicinenet.com]

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]

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]

Effective prevention and therapy of MAC has the potential to contribute substantially to improved quality of life and duration of survival for HIV-infected persons. [cdc.gov]

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