Atypical Mycobacterial Infection Follow-up
- Author: Arry Dieudonne, MD; Chief Editor: Russell W Steele, MD more...
Further Outpatient Care
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- Decrease in fever and a decline in quantity of mycobacteria in blood or tissue can be expected within 2-4 weeks after initiation of appropriate therapy; however, for those with more extensive disease or advanced immunosuppression, clinical response may be delayed.[44, 60] A repeat blood culture for MAC should be obtained in 4-8 weeks after initiation of antimycobacterial therapy for patients who do not have a clinical response to their initial treatment regimen (ie, demonstrate little or no reduction in fever or systemic symptoms). Treatment failure is defined by the absence of clinical response and the persistence of mycobacteremia after 4-8 weeks of treatment.
- Testing of MAC isolates for susceptibility to azithromycin and clarithromycin is recommended for patients who do not respond microbiologically to initial therapy, who have relapse after initial response, or who develop MAC disease while receiving clarithromycin or azithromycin for prophylaxis. Results of susceptibility should be used to construct a new multidrug regimen consisting of at least 2 new drugs not previously used and to which the isolate is susceptible, including the following: ethambutol, rifabutin, ciprofloxacin or levofloxacin, or amikacin. Resistance to clarithromycin in patients with pulmonary disease caused by MAC has been reported. Data are insufficient to support the use of adjunctive treatment with immunomodulators, such as IFN-gamma, TNF-alpha, granulocyte-macrophage colony stimulating factor, and IL-12 alone or in combination with other cytokines, which appear to inhibit intracellular replication or invitrointracellular killing of M avium.
Further Inpatient Care
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- Inpatient care is not mandatory for immunocompromised patients with M avium complex (MAC) disease unless their treatment is complicated by the presence of severe diarrhea with moderate-to-severe dehydration requiring intravenous fluid replacement and hyperalimentation, severe anemia requiring transfusion of blood products, or for further medical investigation.
Inpatient & Outpatient Medications
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- See Medication.
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- Because optimal therapy does not guarantee a better outcome, disseminated MAC disease still carries significant morbidity. Therefore, preventing its occurrence may be the best approach. Data from multicenter studies have shown the presence of resistant strains in patients receiving prophylaxis. With a high frequency rate and a high rate of antimicrobial resistance, primary chemoprophylaxis for MAC infection, in conjunction with effective antiretroviral therapy, should be considered. Prophylaxis for prevention should be offered to children younger than 13 years with the following CD4+ T-lymphocyte counts:
- Children aged 6 years or older with fewer than 50 cells/µL
- Children aged 2-6 years with fewer than 75 cells/µL
- Children aged 1-2 years with fewer than 500 cells/µL
- Children younger than 12 months with fewer than 750 cells/µL
- Azithromycin or clarithromycin is recommended. Rifabutin is another alternative prophylactic agent. However, it should not be used until active tuberculosis has been excluded to avoid the development of rifampin-resistant tuberculosis. Disseminated MAC disease should also be excluded based on a negative blood culture result before prophylaxis is initiated.[66, 83] Discontinuation of prophylaxis for MAC disease in adult patients infected with HIV who have a response to antiretroviral therapy is supported by some published data. Children with a history of disseminated MAC disease should be administered lifelong prophylaxis to prevent recurrence. The safety of discontinuing MAC prophylaxis has not been studied in children whose CD4+ lymphocyte counts have increased in response to HAART.
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- Gastrointestinal obstruction and gastrointestinal bleeding caused by bulky intra-abdominal adenopathy or extensive ileal disease have been reported. Pulmonary complications from disseminated MAC disease are uncommon in children. Culture and histologic evidence of infection have been reported in the heart, eye (keratitis), brain, skin, thyroid, tongue, adrenals, stomach, pancreas, skeletal system, and peripheral nerves.[85, 86, 87]
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- In the early years of the HIV epidemic, descriptive and retrospective studies were mostly aimed at defining the population of children infected with HIV at risk for MAC infection and at analyzing the predictors of survival in patients with AIDS and disseminated MAC disease.[38, 88, 89] MAC was a contributor to mortality in HIV infection, and its presence was considered an indication that death is imminent.[59, 90]
- The development of HAART has resulted in marked changes in the outcome of HIV disease, with reductions in hospitalizations and death as well as opportunistic infections, including MAC. Established treatment, previously discussed, has reduced the morbidity and mortality caused by disseminated MAC disease. MAC infection is still a problem in developing countries where access to antiretroviral therapy is still limited and in severely immunocompromised patients whose adherence and tolerance to treatment raise a lot of questions. The prognosis for children without HIV with disseminated mycobacterial infection secondary to IFN-gamma receptor ligand-binding deficiency is poor.
Masson AM, Prissick FH. Cervical lymphadenitis in children caused by chromogenic Mycobacteria. Can Med Assoc J. 1956 Nov 15. 75(10):798-803. [Medline].
Weed LA, Keith HM, Needham GM. Nontuberculous acid-fast cervical adenitis in children. Mayo Clin Proc. 1956 Apr 18. 31(8):259-63. [Medline].
Wolinsky E. Nontuberculous mycobacteria and associated diseases. Am Rev Respir Dis. 1979 Jan. 119(1):107-59. [Medline].
Silcox VA, Good RC, Floyd MM. Identification of clinically significant Mycobacterium fortuitum complex isolates. J Clin Microbiol. 1981 Dec. 14(6):686-91. [Medline].
Wallace RJ, Brown BA, Silcox VA, et al. Clinical disease, drug susceptibility, and biochemical patterns of the unnamed third biovariant complex of Mycobacterium fortuitum. J Infect Dis. 1991 Mar. 163(3):598-603. [Medline].
Wallace RJ, Silcox VA, Tsukamura M, et al. Clinical significance, biochemical features, and susceptibility patterns of sporadic isolates of the Mycobacterium chelonae-like organism. J Clin Microbiol. 1993 Dec. 31(12):3231-9. [Medline].
Cross JT, Jacobs R. Other mycobacteria. Fegin, Cherry, eds. Textbook of Pediatric Infectious Diseases. Philadelphia, Pa: WB Saunders Co; 1998.
Karne SS, Sangle SA, Kiyawat DS, Dharmashale SN, Kadam DB, Bhardwaj RS. Mycobacterium avium-intracellulare brain abscess in HIV-positive patient. Ann Indian Acad Neurol. 2012 Jan. 15(1):54-5. [Medline]. [Full Text].
Shiratsuchi H, Johnson JL, Ellner JJ. Bidirectional effects of cytokines on the growth of Mycobacterium avium within human monocytes. J Immunol. 1991 May 1. 146(9):3165-70. [Medline].
Denis M, Gregg EO. Recombinant tumour necrosis factor-alpha decreases whereas recombinant interleukin-6 increases growth of a virulent strain of Mycobacterium avium in human macrophages. Immunology. 1990 Sep. 71(1):139-41. [Medline].
Bermudez LE, Wu M, Petrofsky M, Young LS. Interleukin-6 antagonizes tumor necrosis factor-mediated mycobacteriostatic and mycobactericidal activities in macrophages. Infect Immun. 1992 Oct. 60(10):4245-52. [Medline].
Newman GW, Guarnaccia JR, Vance EA 3rd, et al. Interleukin-12 enhances antigen-specific proliferation of peripheral blood mononuclear cells from HIV-positive and negative donors in response to Mycobacterium avium. AIDS. 1994 Oct. 8(10):1413-9. [Medline].
Frucht DM, Holland SM. Defective monocyte costimulation for IFN-gamma production in familialdisseminated Mycobacterium avium complex infection: abnormal IL-12regulation. J Immunol. 1996 Jul 1. 157(1):411-6. [Medline].
Bermudez LE, Wu M, Young LS. Interleukin-12-stimulated natural killer cells can activate humanmacrophages to inhibit growth of Mycobacterium avium. Infect Immun. 1995 Oct. 63(10):4099-104. [Medline].
Chin DP, Hopewell PC. Mycobacterium avium complex in the respiratory or gastrointestinal tract precedes MAC bacteremia. Front Mycobacteria. 1992. 15.
Inderlied CB, Kemper CA, Bermudez LE. The Mycobacterium avium complex. Clin Microbiol Rev. 1993 Jul. 6(3):266-310. [Medline].
Petrofsky M, Bermudez LE. CD4+ T cells but Not CD8+ or gammadelta+ lymphocytes are required for host protection against Mycobacterium avium infection and dissemination through the intestinal route. Infect Immun. 2005 May. 73(5):2621-7. [Medline].
Levin M, Newport MJ, D'Souza S, et al. Familial disseminated atypical mycobacterial infection in childhood: a human mycobacterial susceptibility gene?. Lancet. 1995 Jan 14. 345(8942):79-83. [Medline].
Pierre-Audigier C, Jouanguy E, Lamhamedi S, et al. Fatal disseminated Mycobacterium smegmatis infection in a child withinherited interferon gamma receptor deficiency. Clin Infect Dis. 1997 May. 24(5):982-4. [Medline].
Altare F, Jouanguy E, Lamhamedi-Cherradi S, et al. A causative relationship between mutant IFNgR1 alleles and impaired cellular response to IFN-gamma in a compound heterozygous child. Am J Hum Genet. 1998 Mar. 62(3):723-6. [Medline].
Casanova JL, Newport M, Fischer A. Inherited Interferon-gamma receptor deficiency. Ochs HD et al, eds. Primary Immunodeficiency Diseases. Oxford, England: Oxford University Press; 1999. 209-21.
Dieudonne A, Oleske JM. Pediatric Human Immunodeficiency Virus Infection. Gorbach, Bartlett, Blacklow, eds. Infectious Diseases. 3rd ed. Lippincott Williams and Wilkins; 2004. 1056-99.
Salyer KE, Votteler TP, Dorman GW. Surgical management of cervical adenitis due to atypical mycobacteria inchildren. JAMA. 1968 Jun 17. 204(12):1037-40. [Medline].
MacGregor RR, Hafner R, Wu JW, et al. Clinical, microbiological, and immunological characteristics in HIV-infected subjects at risk for disseminated Mycobacterium avium complex disease: an AACTG study. AIDS Res Hum Retroviruses. 2005 Aug. 21(8):689-95. [Medline].
Merone A, Saggiomo G, Severino G, et al. [Buruli ulcer. A case report]. Minerva Pediatr. 2001 Dec. 53(6):587-90. [Medline].
Thomssen H. [Buruli ulcer. A mycobacterial skin disease]. Hautarzt. 2002 May. 53(5):334-7. [Medline].
Ackumey MM, Gyapong M, Pappoe M, Weiss MG. Help-seeking for pre-ulcer and ulcer conditions of Mycobacterium ulcerans disease (Buruli ulcer) in Ghana. Am J Trop Med Hyg. 2011 Dec. 85(6):1106-13. [Medline]. [Full Text].
Phanzu DM, Mahema RL, Suykerbuyk P, Imposo DH, Lehman LF, Nduwamahoro E, et al. Mycobacterium ulcerans infection (Buruli ulcer) on the face: a comparative analysis of 13 clinically suspected cases from the Democratic Republic of Congo. Am J Trop Med Hyg. 2011 Dec. 85(6):1100-5. [Medline]. [Full Text].
Dankner WM, Lindsey JC, Levin MJ, et al. Correlates of opportunistic infections in children infected with the humanimmunodeficiency virus managed before highly active antiretroviraltherapy. Pediatr Infect Dis J. 2001 Jan. 20(1):40-8. [Medline].
Puthanakit T, Oberdorfer P, Akarathum N, et al. Immune reconstitution syndrome after highly active antiretroviral therapy in human immunodeficiency virus-infected thai children. Pediatr Infect Dis J. 2006 Jan. 25(1):53-8. [Medline].
Johann-Liang R, Cervia JS, Noel GJ. Characteristics of human immunodeficiency virus-infected children at the time of death: an experience in the 1990s. Pediatr Infect Dis J. 1997 Dec. 16(12):1145-50. [Medline].
Keller C, Kirkpatrick S, Lee K, et al. Disseminated Mycobacterium avium complex presenting as hematochezia in an infant with rapidly progressive acquired immunodeficiency syndrome. Pediatr Infect Dis J. 1996 Aug. 15(8):713-5. [Medline].
Centers for Disease Control and Prevention. 2001 USPHS/IDSA guidelines for the prevention of opportunistic infections in persons infected with human immunodeficiency virus. MMWR. November 28, 2001. [Full Text].
Rutstein RM, Cobb P, McGowan KL, et al. Mycobacterium avium intracellulare complex infection in HIV-infected children. AIDS. 1993 Apr. 7(4):507-12. [Medline].
Le Bourgeois M, Sermet-Gaudelus I, Catherinot E, Gaillard JL. [Nontuberculous mycobacteria in cystic fibrosis]. Arch Pediatr. 2005 Aug. 12 Suppl 2:S117-21. [Medline].
Mussaffi H, Rivlin J, Shalit I, et al. Nontuberculous mycobacteria in cystic fibrosis associated with allergic bronchopulmonary aspergillosis and steroid therapy. Eur Respir J. 2005 Feb. 25(2):324-8. [Medline].
Horsburgh CR Jr, Caldwell MB, Simonds RJ. Epidemiology of disseminated nontuberculous mycobacterial disease in children with acquired immunodeficiency syndrome. Pediatr Infect Dis J. 1993 Mar. 12(3):219-22. [Medline].
Hoyt L, Oleske J, Holland B, Connor E. Nontuberculous mycobacteria in children with acquired immunodeficiency syndrome. Pediatr Infect Dis J. 1992 May. 11(5):354-60. [Medline].
Hartmann P, Plum G. Immunological defense mechanisms in tuberculosis and MAC-infection. Diagn Microbiol Infect Dis. 1999 Jun. 34(2):147-52. [Medline].
O'Brien RJ. The epidemiology of nontuberculous mycobacterial disease. Clin Chest Med. 1989 Sep. 10(3):407-18. [Medline].
Schonell ME, Crofton JW, Stuart AE, Wallace A. Disseminated infection with Mycobacterium avium: I. Clinical features,treatment and pathology. Tubercle. 1968 Mar. 49(1):12-30. [Medline].
Dieudonne A, McSherry, GD, Holland B. Clinical outcome and survival time in a cohort of HIV-infected children with atypical mycobacterial infections. Abstract Book. Annual Meeting of Society of Pediatric Research. 1997. Abstract 697:
Dieudonne A. Mycobacterium avium complex in HIV-infected infants and adolescents. Medical CME Program. Medical Word Communications. 1996. 8-10:
Kayal JD, McCall CO. Sporotrichoid cutaneous Mycobacterium avium complex infection. J Am Acad Dermatol. 2002 Nov. 47(5 Suppl):S249-50. [Medline].
Astagneau P, Desplaces N, Vincent V, et al. Mycobacterium xenopi spinal infections after discovertebral surgery: investigation and screening of a large outbreak. Lancet. 2001 Sep 1. 358(9283):747-51. [Medline].
Brutus JP, Baeten Y, Chahidi N, et al. Atypical mycobacterial infections of the hand: report of eight cases and literature review. Chir Main. 2001 Aug. 20(4):280-6. [Medline].
Arend SM, Janssen R, Gosen JJ, et al. Multifocal osteomyelitis caused by nontuberculous mycobacteria in patients with a genetic defect of the interferon-gamma receptor. Neth J Med. 2001 Sep. 59(3):140-51. [Medline].
Nakamura T, Yamamura Y, Tsuruta T, et al. Mycobacterium kansasii arthritis of the foot in a patient with systemic lupus erythematosus. Intern Med. 2001 Oct. 40(10):1045-9. [Medline].
Villella A, Picard C, Jouanguy E, et al. Recurrent Mycobacterium avium osteomyelitis associated with a novel dominant interferon gamma receptor mutation. Pediatrics. 2001 Apr. 107(4):E47. [Medline].
Lidar M, Elkayam O, Goodwin D, et al. Protracted Mycobacterium kansasii carpal tunnel syndrome and tenosynovitis. Isr Med Assoc J. 2003 Jun. 5(6):453-4. [Medline].
De Smet L. Mycobacterium marinum infections of the hand: a report of three cases. Acta Chir Belg. 2008 Nov-Dec. 108(6:779-82. [Medline].
Tigges F, Bauer A, Hochauf K, Meurer M. Sporotrichoid atypical cutaneous infection caused by Mycobacterium marinum. Acta Dermatovenerol Alp Panonica Adriat. 2009 Mar. 18(1):31-4 [PubMed - in process]. [Medline].
Azzam HC, Gahunia MK, Sae-Tia, Santoro J. Mycobacterium avium--associated typhlitis mimicking appendicitis in an immunocompetent host. Am J Med Sci. 2009 Mar. 337(3):218-20. [Medline].
Thaunat O, Morelon E, Stern M, et al. Mycobacterium xenopi pulmonary infection in two renal transplant recipients under sirolimus therapy. Transpl Infect Dis. 2004 Dec. 6(4):179-82. [Medline].
Stelzmueller I, Dunst KM, Wiesmayr S, et al. Mycobacterium chelonae skin infection in kidney-pancreas recipient. Emerg Infect Dis. 2005 Feb. 11(2):352-4. [Medline].
Wright HL, Thomson RM, Reid AB, Carter R, Bartley PB, Newton P, et al. Rapidly growing mycobacteria associated with laparoscopic gastric banding, Australia, 2005-2011. Emerg Infect Dis. 2014 Oct. 20(10):1612-9. [Medline]. [Full Text].
Hackethal V. Gastric Banding Linked to Mycobacterium Infections. Medscape Medical News. Available at http://www.medscape.com/viewarticle/831462. Accessed: January 7, 2015.
Havlir D, Elnner JJ. Mycobacterium avium complex. Principle and Practice of Infectious Diseases. New York, NY: Churchill Livingstone; 2000. Vol 2: 2616-30.
Chaisson RE, Moore RD, Richman DD, et al. Incidence and natural history of Mycobacterium avium-complex infections inpatients with advanced human immunodeficiency virus disease treated withzidovudine. The Zidovudine Epidemiology Study Group. Am Rev Respir Dis. 1992 Aug. 146(2):285-9. [Medline].
Lim SD, Todd J, Lopez J, et al. Genotypic identification of pathogenic Mycobacterium species by using a nonradioactive oligonucleotide probe. J Clin Microbiol. 1991 Jun. 29(6):1276-8. [Medline].
Phillips P, Zala C, Rouleau D. Mycobacterial lymphadenitis: Can highly active antiretroviral therapy (HAART) unmask subclinical infection? Abstract 351. In: Program and Abstracts of the 4th Conference on Retroviruses and Opportunistic Infections. January 22-26, 1997:
Race EM, Adelson-Mitty J, Kriegel GR, et al. Focal mycobacterial lymphadenitis following initiation ofprotease-inhibitor therapy in patients with advanced HIV-1 disease. Lancet. 1998 Jan 24. 351(9098):252-5. [Medline].
Kaplan MH. Mycobacterium avium-intracellulare (MAIS) reversal syndrome set off by highly active and anti-retroviral therapy (HAART). Improved immunity is not always good but it is better than no immunity. Abstract 726. In: Program and Abstracts of the 5th Conference. Alexandria, Va: Foundation for Retrovirology and Human Health. February 1-5, 1998:
Shafran SD. Prevention and treatment of disseminated Mycobacterium avium complexinfection in human immunodeficiency virus-infected individuals. Int J Infect Dis. 1998 Jul-Sep. 3(1):39-47. [Medline].
Wallace RJ, Musser JM, Hull SI, et al. Diversity and sources of rapidly growing mycobacteria associated with infections following cardiac surgery. J Infect Dis. 1989 Apr. 159(4):708-16. [Medline].
American Academy of Pediatrics. Diseases caused by nontuberculous Mycobacteria. Pickering LK, ed. 2006 Red Book: Report of the Committee on Infectious Diseases. 27th ed. Elk Grove Village, Ill: American Academy of Pediatrics; 2006.
Stone AB, Schelonka RL, Drehner DM, et al. Disseminated Mycobacterium avium complex in non-human immunodeficiency virus-infected pediatric patients. Pediatr Infect Dis J. 1992 Nov. 11(11):960-4. [Medline].
Dhooge I, Dhooge C, De Baets F, Van Cauwenberge P. Diagnostic and therapeutic management of atypical mycobacterial infections in children. Eur Arch Otorhinolaryngol. 1993. 250(7):387-91. [Medline].
Da Silva Telles MA, Chimara E, Ferrazoli L, Riley LW. Mycobacterium kansasii: antibiotic susceptibility and PCR-restriction analysis of clinical isolates. J Med Microbiol. 2005 Oct. 54(Pt 10):975-9. [Medline].
Hartman TE, Swensen SJ, Williams DE. Mycobacterium avium-intracellulare complex: evaluation with CT. Radiology. 1993 Apr. 187(1):23-6. [Medline].
Tamura A, Muraki K, Shimada M, et al. [Usefulness of bronchofiberscopy for the diagnosis of pulmonary non-tuberculous mycobacteriosis--an analysis mainly on pulmonary M. avium complex disease]. Kekkaku. 2008 Dec. 83(12):785-91. [Medline].
Nyberg DA, Federle MP, Jeffrey RB, et al. Abdominal CT findings of disseminated Mycobacterium avium-intracellularein AIDS. AJR Am J Roentgenol. 1985 Aug. 145(2):297-9. [Medline].
Robbins SL, Cotran RS, Kumar V. Pathologic basis of disease. 1984, Saunders, third edition. 300-350.
Torriani FJ, McCutchan JA, Bozzette SA, et al. Autopsy findings in AIDS patients with Mycobacterium avium complexbacteremia. J Infect Dis. 1994 Dec. 170(6):1601-5. [Medline].
Rustom IK, Sandoe JA, Makura ZG. Paediatric neck abscesses: microbiology and management. J Laryngol Otol. 2007 Jun 11. 1-5. [Medline].
Griffith DE, Brown BA, Girard WM, et al. Azithromycin-containing regimens for treatment of Mycobacterium avium complex lung disease. Clin Infect Dis. 2001 Jun 1. 32(11):1547-53. [Medline].
Aberg JA, Yajko DM, Jacobson MA. Eradication of AIDS-related disseminated mycobacterium avium complex infection after 12 months of antimycobacterial therapy combined with highly active antiretroviral therapy. J Infect Dis. 1998 Nov. 178(5):1446-9. [Medline].
Gordin FM, Sullam PM, Shafran SD, et al. A randomized, placebo-controlled study of rifabutin added to a regimen of clarithromycin and ethambutol for treatment of disseminated infection with Mycobacterium avium complex. Clin Infect Dis. 1999 May. 28(5):1080-5. [Medline].
Ramirez J, Mason C, Ali J, Lopez FA. Mycobacterium avium complex pulmonary disease: management options in HIV-negative patients. J La State Med Soc. 2008 Sep-Oct. 160(5):248-54; quiz 254, 293. [Medline].
Huang JH, Kao PN, Adi V, Ruoss SJ. Mycobacterium avium-intracellulare pulmonary infection in HIV-negative patients without preexisting lung disease: diagnostic and management limitations. Chest. 1999 Apr. 115(4):1033-40. [Medline]. [Full Text].
Schütte D, Umboock A, Pluschke G. Phagocytosis of Mycobacterium ulcerans in the course of rifampicin and streptomycin chemotherapy in Buruli ulcer lesions. Br J Dermatol. Feb. 2009. 273-283. [Medline].
Kuwabara K, Tsuchiya T. [Clinical features and treatment history of clarithromycin resistance in M. avium-intracellulare complex pulmonary disease patients]. Nihon Kokyuki Gakkai Zasshi. 2007 Aug. 45(8):587-92. [Medline].
Centers for Disease Control and Prevention. 2002 USPHS/IDSA guidelines for prevention of opportunistic infections in persons with HIV. MMWR. 2002. [Full Text].
El-Sadr WM, Burman WJ, Grant LB, et al. Discontinuation of prophylaxis for Mycobacterium avium complex disease in HIV-infected patients who have a response to antiretroviral therapy. Terry Beirn Community Programs for Clinical Research on AIDS. N Engl J Med. 2000 Apr 13. 342(15):1085-92. [Medline].
Hawkins CC, Gold JW, Whimbey E, et al. Mycobacterium avium complex infections in patients with the acquired immunodeficiency syndrome. Ann Intern Med. 1986 Aug. 105(2):184-8. [Medline].
Wallace RJ Jr. Mycobacterium avium complex lung disease and women. Now an equal opportunity disease. Chest. 1994 Jan. 105(1):6-7. [Medline].
Sohn CC, Schroff RW, Kliewer KE, et al. Disseminated Mycobacterium avium-intracellulare infection in homosexual men with acquired cell-mediated immunodeficiency: a histologic and immunologic study of two cases. Am J Clin Pathol. 1983 Feb. 79(2):247-52. [Medline].
Horsburgh CR, Metchock B, Gordon SM, et al. Predictors of survival in patients with AIDS and disseminated Mycobacterium avium complex disease. J Infect Dis. 1994 Sep. 170(3):573-7. [Medline].
Lewis LL, Butler KM, Husson RN, et al. Defining the population of human immunodeficiency virus-infected children at risk for Mycobacterium avium-intracellulare infection. J Pediatr. 1992 Nov. 121(5 Pt 1):677-83. [Medline].
Jacobson MA, Hopewell PC, Yajko DM, et al. Natural history of disseminated Mycobacterium avium complex infection in AIDS. J Infect Dis. 1991 Nov. 164(5):994-8. [Medline].
Dhillon SS, Watanakunakorn C. Lady Windermere syndrome: middle lobe bronchiectasis and Mycobacterium avium complex infection due to voluntary cough suppression. Clin Infect Dis. 2000 Mar. 30(3):572-5. [Medline].
Duraipandian J, Rengasamy G, Madasamy B, Kulanthaivelu A, Subramanian G. Subcutaneous aspergillosis with coexisting atypical mycobacterial infection. Indian J Pathol Microbiol. 2010 Apr-Jun. 53(2):359-60. [Medline].
Hadad DJ, Lewi DS, Pignatari AC. Resolution of MAC bacteremia following highly active antiretroviral therapy. Abstract. In: Fifth Conference on Retroviruses and Opportunistic infections. 1998.
Herbinger KH, Brieske D, Nitschke J, Siegmund V et al. Excision of pre-ulcerative forms of Buruli ulcer disease: a curative treatment?. Infection. Feb 2009. 37(1):20-5. [Medline].
Jouanguy E, Altare F, Lamhamedi-Cherradi S, Casanova JL. Infections in IFNGR-1-deficient children. J Interferon Cytokine Res. 1997 Oct. 17(10):583-7. [Medline].
Moore RD, Keruly JC, Chaisson RE. Decline in CMV and other opportunistic disease with combination antiretroviral therapy. Abstract 184. In: Program and Abstracts. of the 5th Conference on Retroviruses and Opportunistic Infections. Chicago, Ill: February 1-5,1998:
Murphy R, El-Sadr W, Cheung T. Impact of protease inhibitor-containing regimen on the risk of developing opportunistic infections and mortality in the CPCRA 034/ACTG 277 study. Abstract 181. In: Program and Abstracts. of the 5th Conference on Retroviruses and Opportunistic Infections. Chicago, Ill: February 1-5,1998:
Newport MJ, Huxley CM, Huston S, et al. A mutation in the interferon-gamma-receptor gene and susceptibility to mycobacterial infection. N Engl J Med. 1996 Dec 26. 335(26):1941-9. [Medline].
Nightingale SD, Byrd LT, Southern PM, et al. Incidence of Mycobacterium avium-intracellulare complex bacteremia in human immunodeficiency virus-positive patients. J Infect Dis. 1992 Jun. 165(6):1082-5. [Medline].