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Have any members the wisdom on what has caused cavitation and intermittent fevers with production of offensive sputum? Remedies have assisted greatly but not eradicated.

Tags: Intracellulare, Mycobacterium

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Mycobacterium avium complex (MAC) consists of two species: M avium andM intracellulare; because these species are difficult to differentiate, they are also collectively referred to as Mycobacterium avium-intracellulare (MAI) .MAC is the atypical Mycobacterium most commonly associated with human disease.

MAC is primarily a pulmonary pathogen that affects individuals who are immune compromised (eg, from AIDS, hairy cell leukemia, immunosuppressive chemotherapy). In this clinical setting, MAC has been associated with osteomyelitis; tenosynovitis; synovitis; and disseminated disease involving the lymph nodes, the CNS, the liver, the spleen, and the bone marrow. MAC is the most common cause of infection by nontuberculous mycobacteria (NTM) in patients with AIDS. M avium is the isolate in more than 95% of patients with AIDS who develop MAC infections.

MAC lung disease occurs rarely in immunocompetent hosts. Patients with underlying lung disease or immunosuppression may develop progressive MAC lung disease. M intracellulare is responsible for 40% of such infections in immunocompetent patients.

MAC is ubiquitous in distribution. It has been isolated from fresh water and salt water worldwide. The common environmental sources of MAC include the following:

  • Aerosolized water
  • Piped hot water systems (including household and hospital water supplies)
  • Bathrooms[1]
  • House dust
  • Soil
  • Birds
  • Farm animals
  • Cigarette components (eg, tobacco, filters, paper)

In patients who may have pulmonary infection with Mycobacterium aviumcomplex (MAC), diagnostic testing includes acid-fast bacillus (AFB) staining and culture of sputum specimens. If disseminated MAC (DMAC) infection is suspected, culture specimens should also include blood and urine. (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). Aminoglycosides, such as streptomycin and amikacin, are also used as additional agents. MAC lymphadenitis in children is treated with surgical excision of the affected lymph nodes. (See Treatment.)

Source: E-Medicine

Definition of Cavitation: The formation of cavities in a body tissue or an organ, especially those cavities that form in the lung as a result of tuberculosis.

Thank you. I too found this.  The treatment regime not attractive and if cavitation present not certain will cure.

I suspect this is a lot more common than known as one needs to request a special culture that takes up to 6 weeks. Thanks again Debby

Dear Jean ~ Can you further elaborate upon your question? It sounds as if you are either doing some research on the topic, or have noticed some changes in patients pathology.

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