Mycobacterium avium Complex MAC

Pulmonary and disseminated infections; primary form occurs in healthy non-smokers ( Lady Windermere syndrome ); secondary pulmonary form affects patients with preexisting pulmonary disease (eg. COPD , CF, TB)

• History / PE:
  Fever, weight loss
  +/- hepatosplenomegaly, lymphadenopathy, adrenal insufficiency
• Diagnosis:
  + blood cultures
  Increase in alkaline phosphatase and LDH
  Biopsy reveals foamy macrophages with acid-fast bacilli
• Treatment:
  Clarithromycin, Ethambutol +/- rifabutin, and HAART
  Continue tx for > 12 months and until CD4+ count > 100 for > 6 months
• Keywords:
  Increase Alk Phos, LDH, foamy macrophages, HAART