Disseminated infection with Mycobacterium avium-intracellulare. A report of 13 cases and a review of the literature.

摘要: Thirteen cases of disseminated infection with Mycobacterium avium-intracellulare (MAI) seen at the National Jewish Hospital and Research Center 24 from literature were analyzed to define clinical therapeutic features disease. Disseminated MAI was a disease immunocompromised apparently normal hosts. It acquired environment by unknown mechanisms, usually entering body through lungs spreading include reticuloendothelial system, bones, less commonly, skin. Diagnosis often delayed required culture tissue or secretions. Medical personnel must maintain high index suspicion for disease, especially in These patients should be monitored carefully evidence frequent cultures blood bone marrow. Blood systems able recover promptly reliably employed (52, 64). New diagnostic aids, such as standardized preparation PPD-B currently being prepared tests antibody MAI, will help differentiating other processes. If is recovered, broad-spectrum therapy instituted. Response combination antimicrobial chemotherapy surveyed this report gratifying. Over two-thirds treated responded therapy. antimycobacterial agents ansamycin thienamycin have been shown activity against vitro (40, 81, 92) may further improve efficacy. Studies synergy, progress our laboratory, also optimal regimen each individual patient. While presented had reassuring response therapy, those who many bacilli tissues poorer outcome. Patients AIDS lepromatous histology (37) thus respond more poorly than even when employed. Careful monitoring permit earlier institution chances control infection. assess relationship sensitivity these are underway laboratory. hoped that early optimization regimens according data lead decreased morbidity mortality all