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Definition
History and exam
Key diagnostic factors
- doença pulmonar subjacente
- tosse produtiva crônica
- dispneia
- perda de peso
- fadiga
- febre
- linfadenopatia
- imunocomprometido
- uso de banheira de hidromassagem
Other diagnostic factors
- idade abaixo de 5 anos
- meia idade a idade avançada
- sudorese noturna
- dor abdominal
- diarreia
- roncos/estertores
- hepatomegalia
- esplenomegalia
- compleição magra
- péctus excavatum
- escoliose
- sopro e clique sistólico
Risk factors
- doenças pulmonares subjacentes
- tabagismo
- uso excessivo de bebidas alcoólicas
- idade mais avançada
- uso de banheira de hidromassagem
- Vírus da imunodeficiência humana (HIV)/síndrome de imunodeficiência adquirida (AIDS)
- imunossupressão grave
- defeitos de citocina genéticos
Diagnostic investigations
1st investigations to order
- Hemograma completo com diferencial
- testes da função hepática
- radiografia torácica
- cultura de escarro
- hemocultura
Investigations to consider
- rastreamento de tomografia computadorizada de alta resolução (TCAR)
- aspirado de medula óssea para cultura
- broncoscopia/lavagem brônquica
- biópsia pulmonar
- biópsia de linfonodos
Emerging tests
- reação em cadeia da polimerase
Treatment algorithm
MAC pulmonar
MAC disseminado
Linfadenite por MAC
Pneumonite por hipersensibilidade por MAC
Contributors
Authors
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
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.
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
- Tuberculose pulmonar
- Outras micobactérias não tuberculosas (MNT)
- Linfoma relacionado ao vírus da imunodeficiência humana (HIV)
更多 鉴别诊断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
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