Introduction
Epidemiology
Patients with advanced AIDS (CD4 <50/mm3)
Pathobiology
Not contagious among human
?: M.avium complex (MAC, 50%), M.abscessus (20%)
MAC = M.avium & M.intracellulare
Clinical manifestations
Disseminated disease
Pulmonary disease
Cervical lymph nodes
Skin and soft tissue disease
M.marinum
Skin and soft tissue infection following exposure to water
Diagnosis
- Sputum
- NTM in sputum? ? only 10~25% is genuine infection.
- Just colonization without Sx doesn’t need any Tx.
- Discrimination from TB ? PCR followed by culture
Prevention
Treatment
Difficult d/t highly resistant and frequent recur, uncertain treatment period
MAC
Macrolide (eg, clarithromycin, azithromycin) + ethambutol
+/- rifabutin or ciprofloxacin, 12month after (-)
M.intracellulare
M.abscessus
Clarithromycin + amikacin + cefoxitin
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