Patients with skin/soft tissue infections were more commonly female (58%), whereas disseminated infections occurred predominantly in male patients (67%); of these, 79% of patients had MAC infection
In both cases of MAC causing HLH, correct diagnosis was delayed highlighting the difficulty of promptly identifying MAC infection
with currently available diagnostic technology.
During the ART era, MAC infection
has developed into a completely new disease.
1) While MAC is ubiquitous in the environment and is the most common disease-causing NTM in humans, there are very few reported cases of MAC infection
in the urine and only two reported cases of asymptomatic MAC urine infection.
showed that CA 19-9 was a marker for the deterioration of a MAC infection
in association with BMI and CRP.
The granulomas in MAC infection
are small ill-formed with proliferation of foamy macrophages.
Unmasking IRD comprised 4 patients with tuberculosis and 2 with MAC infection
9) Together, the development of highly active anti-retroviral (HAART) therapy for AIDS and effective macrolide-based prophylaxis and treatment regimens against disseminated MAC almost relegated MAC infection
in AIDS patients to a problem of the past, but not quite.
The AIDS Clinical Trials Group 362 study, reported in abstract form at the recent Interscience Conference on Antimicrobial Agents and Chemotherapy showed no cases of disseminated MAC infection
in 643 HIV-positive patients randomized to a year of weekly azithromycin prophylaxis or placebo, according to Dr.
3) Although the detection of MAC organisms in the respiratory or gastrointestinal tract may be predictive of the development of disseminated MAC infection
, no data are available on the efficacy of prophylaxis with clarithromycin, azithromycin, rifabutin, or other drugs in patients with MAC organisms at these sites and a negative blood culture.
It has been estimated by world health authorities that more than 70 percent of AIDS patients harbor an MAC infection
We excluded patients with NTM-positive specimens collected before 2010 because acid-fast bacillus tissue cultures before 2010 were not included in the microbiology database; patients with a history of MAC infection
(or a MAC-positive specimen) before cardiothoracic surgery, which suggests that their infection could not be temporally attributed to their cardiac surgery; patients whose cardiothoracic surgeries occurred before 2009, because surgical documentation in the electronic medical record at that time was less standardized and reliable; and patients with only NTM-positive pulmonary specimens, because patients with pulmonary infections have been shown to differ epidemiologically from patients with other types of NTM infections (11,18).