Mycobacterium avium complex
Summary
Definition
病史和体格检查
关键诊断因素
- underlying lung disease
- chronic productive cough
- dyspnea
- weight loss
- fatigue
- fever
- lymphadenopathy
- immunocompromised
- hot tub use
其他诊断因素
- age under 5 years
- middle-to-old age
- night sweats
- abdominal pain
- diarrhea
- rhonchi/crackles
- hepatomegaly
- splenomegaly
- thin body habitus
- pectus excavatum
- scoliosis
- systolic click and murmur
危险因素
- underlying lung diseases
- smoking
- excessive alcohol use
- increasing age
- hot tub use
- HIV/AIDS
- severe immunosuppression
- genetic cytokine defects
诊断性检查
首要检查
- CBC with differential
- LFT
- chest x-ray
- sputum culture
- blood culture
需考虑的检查
- high-resolution CT (HRCT) scanning
- bone marrow aspirate for culture
- bronchoscopy/bronchial lavage
- lung biopsy
- lymph node biopsy
新兴检查
- polymerase chain reaction
治疗流程
pulmonary MAC
disseminated MAC
MAC lymphadenitis
MAC hypersensitivity pneumonitis
撰稿人
作者
Zelalem Temesgen, MD, FIDSA
Professor of Medicine
Director, Mayo Clinic Center for Tuberculosis
Director, HIV Program
Consultant, Division of Infectious Diseases
Mayo Clinic
Rochester
MN
利益声明
ZT declares that he has no competing interests.
鸣谢
Dr Temesgen would like to gratefully acknowledge Dr Dereje S. Ayo, a previous contributor to this topic.
利益声明
DSA declares that he has no competing interests.
同行评议者
Jonathan P. Parsons, MD
Assistant Professor
Division of Pulmonary, Allergy, Critical Care and Sleep Medicine
Ohio State University Medical Center
Columbus
OH
利益声明
JPP declares that he has no competing interests.
Sandro Vento, MD
Director
Infectious Diseases Unit
Annunziata Hospital
Cosenza
Italy
利益声明
SV declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
National Institutes of Health, Centers for Disease Control and Prevention, HIV Medicine Association, and Infectious Diseases Society of America. Panel on Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: Disseminated mycobacterium avium complex disease. 2024 [internet publication].全文
Griffith DE, Aksamit T, Brown-Elliott BA, et al. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med. 2007 Feb 15;175(4):367-416.全文 摘要
Daley CL, Iaccarino JM, Lange C, et al. Treatment of nontuberculous mycobacterial pulmonary disease: an official ATS/ERS/ESCMID/IDSA clinical practice guideline. Clin Infect Dis. 2020 Aug 14;71(4):e1-36.全文 摘要
Haworth CS, Banks J, Capstick T, et al. British Thoracic Society guidelines for the management of non-tuberculous mycobacterial pulmonary disease (NTM-PD). Thorax. 2017 Nov;72(suppl 2):ii1-64.全文
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Pulmonary tuberculosis
- Other nontuberculous mycobacteria (NTM)
- HIV-related lymphoma
更多 鉴别诊断指南
- Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV
- Guidelines for the prevention and treatment of opportunistic infections in children with and exposed to HIV
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