Abstract
Pulmonary disease due to Mycobacterium avium complex (MAC) without evidence of dissemination is uncommon in HIV-infected patients. Five cases were observed over a 2-year period. All patients had AIDS and the median CD4 cell count at the time of presentation was 90 x 10(6)/L. Radiographic patterns included unilobar alveolar infiltrates or diffuse alveolar densities. All patients had a favorable clinical response to antimycobacterial chemotherapy with a median follow-up period of 10 months. MAC should be considered in HIV-infected patients with positive respiratory samples for acid-fast bacilli and pulmonary infiltrates. Patients with such findings in whom presumptive therapy for tuberculosis has failed should receive broad-spectrum antimycobacterial chemotherapy until final identification is available.
MeSH terms
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AIDS-Related Opportunistic Infections / diagnostic imaging
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AIDS-Related Opportunistic Infections / drug therapy
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AIDS-Related Opportunistic Infections / pathology*
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Adult
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Anti-Bacterial Agents / therapeutic use
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Antibiotics, Antitubercular / therapeutic use
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Antitubercular Agents / therapeutic use
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CD4 Lymphocyte Count
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Clarithromycin / therapeutic use
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Ethambutol / therapeutic use
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Follow-Up Studies
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HIV Infections / complications*
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Humans
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Male
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Middle Aged
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Mycobacterium avium-intracellulare Infection / diagnostic imaging
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Mycobacterium avium-intracellulare Infection / drug therapy
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Mycobacterium avium-intracellulare Infection / pathology*
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Pulmonary Alveoli / diagnostic imaging
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Rifabutin / therapeutic use
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Tomography, X-Ray Computed
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Tuberculosis, Pulmonary / diagnostic imaging
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Tuberculosis, Pulmonary / drug therapy
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Tuberculosis, Pulmonary / pathology*
Substances
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Anti-Bacterial Agents
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Antibiotics, Antitubercular
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Antitubercular Agents
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Rifabutin
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Ethambutol
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Clarithromycin