Summary
Definition
History and exam
Key diagnostic factors
- underlying lung disease
- chronic productive cough
- dyspnea
- weight loss
- fatigue
- fever
- lymphadenopathy
- immunocompromised
- hot tub use
Other diagnostic factors
- age under 5 years
- middle-to-old age
- night sweats
- abdominal pain
- diarrhea
- ronchi/crackles
- hepatomegaly
- splenomegaly
- thin body habitus
- pectus excavatum
- scoliosis
- systolic click and murmur
Risk factors
- underlying lung diseases
- smoking
- excessive alcohol use
- older men
- postmenopausal women
- hot tub use
- HIV/AIDS
- severe immunosuppression
- genetic cytokine defects
Diagnostic investigations
1st investigations to order
- CBC with differential
- LFT
- chest x-ray
- sputum culture
- blood culture
Investigations to consider
- high-resolution CT (HRCT) scanning
- bone marrow aspirate for culture
- bronchoscopy/bronchial lavage
- lung biopsy
- lymph node biopsy
Emerging tests
- polymerase chain reaction
Treatment algorithm
pulmonary MAC
disseminated MAC
MAC lymphadenitis
MAC hypersensitivity pneumonitis
Contributors
Authors
Zelalem Temesgen, MD, FIDSA

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 nontuberculous mycobacteria (NTM)
- HIV-related lymphoma
More DifferentialsGuidelines
- Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV
- Treatment of nontuberculous mycobacterial pulmonary disease
More GuidelinesPatient leaflets
Quitting smoking
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