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Mycobacterium avium complex

Last reviewed: 1 Apr 2025
Last updated: 03 Apr 2025

Summary

Definition

History and exam

Key diagnostic factors

  • underlying lung disease
  • chronic productive cough
  • dyspnea
  • weight loss
  • fatigue
  • fever
  • lymphadenopathy
  • immunocompromised
  • hot tub use
Full details

Other diagnostic factors

  • 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
Full details

Risk factors

  • underlying lung diseases
  • smoking
  • excessive alcohol use
  • increasing age
  • hot tub use
  • HIV/AIDS
  • severe immunosuppression
  • genetic cytokine defects
Full details

Diagnostic tests

1st tests to order

  • CBC with differential
  • LFT
  • chest x-ray
  • sputum culture
  • blood culture
Full details

Tests to consider

  • high-resolution CT (HRCT) scanning
  • bone marrow aspirate for culture
  • bronchoscopy/bronchial lavage
  • lung biopsy
  • lymph node biopsy
Full details

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

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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

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].Full text

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.Full text  Abstract

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.Full text  Abstract

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.Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Differentials

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

    • 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
    More Guidelines
  • Patient information

    Quitting smoking

    More Patient information
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