infections
Infections Caused by Bacteria Related to Tuberculosis (TB)
Mycobacterium aviumComplex (MAC) Infections
MAC infections of the lungs usually develop slowly. The first symptoms include coughing and spitting up mucus. People may feel tired, lose weight, and have a low-grade fever. The infection may progress slowly or remain stable for long periods of time. If it progresses, people may regularly spit up blood and have trouble breathing. Laboratory analysis of sputum taken from the infected person is needed to distinguish a MAC infection from tuberculosis. A chest x-ray is taken. It can show some differences between tuberculosis and a MAC infection. Because drug resistance is often a problem when treating MAC infections, doctors tend to give infected people a combination of antibiotics. A combination of three drugs—clarithromycinorazithromycin,rifampin, andethambutol—is often used for people who have a moderate infection. Drugs are usually taken for 12 to 18 months. If this combination is ineffective, other combinations are tried. Combinations of 4 to 6 other drugs are given to people who have an infection that is getting worse. MAC infection of the lymph nodes may develop in children, typically those aged 1 to 5 years. The infection is usually caused by eating soil or drinking water that is contaminated with the mycobacteria. To diagnose the infection, doctors remove and test an affected lymph node. Antibiotics are usually not necessary to cure the infection. Instead, the infected lymph nodes may be removed surgically. A MAC infection can spread throughout the body in the following people: People with advanced AIDS Sometimes people who have other disorders or take drugs that weaken the immune system Symptoms include a fever, anemia, blood disorders, diarrhea, and abdominal pain. To diagnosis widespread MAC infection, doctors usually try to grow (culture) the bacteria from a sample of blood or from tissue taken from the bone marrow, the liver, or an infected lymph node. These infections are treated with two or three antibiotics, oftenclarithromycinorazithromycinplusethambutoland sometimesrifabutin. People with severe AIDS and a CD4 count of less than 100 cells per microliter of blood need to take 