Mycobacterium avium complex

Last reviewed: 1 Sep 2022
Last updated: 04 May 2021

Summary

Definition

History and exam

Key diagnostic factors

  • underlying lung disease
  • chronic productive cough
  • dyspnoea
  • weight loss
  • fatigue
  • fever
  • lymphadenopathy
  • immunocompromised
  • hot tub use
More key diagnostic factors

Other diagnostic factors

  • age under 5 years
  • middle-to-old age
  • night sweats
  • abdominal pain
  • diarrhoea
  • ronchi/crackles
  • hepatomegaly
  • splenomegaly
  • thin body habitus
  • pectus excavatum
  • scoliosis
  • systolic click and murmur
Other diagnostic factors

Risk factors

  • underlying lung diseases
  • smoking
  • excessive alcohol use
  • older men
  • post-menopausal women
  • hot tub use
  • HIV/AIDS
  • severe immunosuppression
  • genetic cytokine defects
More risk factors

Diagnostic investigations

1st investigations to order

  • FBC with differential
  • LFT
  • chest x-ray
  • sputum culture
  • blood culture
More 1st investigations to order

Investigations to consider

  • high-resolution CT (HRCT) scanning
  • bone marrow aspirate for culture
  • bronchoscopy/bronchial lavage
  • lung biopsy
  • lymph node biopsy
More investigations to consider

Emerging tests

  • polymerase chain reaction

Treatment algorithm

ONGOING

pulmonary MAC

disseminated MAC

MAC lymphadenitis

MAC hypersensitivity pneumonitis

Contributors

Authors

Zelalem Temesgen, MD, FIDSA
Zelalem Temesgen

Professor of Medicine

Director, Mayo Clinic Center for Tuberculosis – A World Health Organization – Collaborating Center in Digital Health and Precision Medicine

Director, HIV Program

Consultant, Division of Infectious Diseases

Mayo Clinic

Rochester

MN

Disclosures

ZT declares that he has no competing interests.

Acknowledgements

Dr Temesgen would like to gratefully acknowledge Dr Dereje S. Ayo, a previous contributor to this topic.

Disclosures

DSA declares that he has no competing interests.

Peer reviewers

Jonathan P. Parsons, MD

Assistant Professor

Division of Pulmonary, Allergy, Critical Care and Sleep Medicine

Ohio State University Medical Center

Columbus

OH

Disclosures

JPP declares that he has no competing interests.

Sandro Vento, MD

Director

Infectious Diseases Unit

Annunziata Hospital

Cosenza

Italy

Disclosures

SV declares that he has no competing interests.

  • Differentials

    • Pulmonary tuberculosis
    • Other non-tuberculous mycobacteria (NTM)
    • HIV-related lymphoma
    More Differentials
  • Guidelines

    • Treatment of nontuberculous mycobacterial pulmonary disease
    • Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV
    More Guidelines
  • Patient leaflets

    Stopping smoking

    More Patient leaflets
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer