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Complexo Mycobacterium avium

Última revisão: 14 Aug 2025
Última atualização: 03 Apr 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • doença pulmonar subjacente
  • tosse produtiva crônica
  • dispneia
  • perda de peso
  • fadiga
  • febre
  • linfadenopatia
  • imunocomprometido
  • uso de banheira de hidromassagem
Detalhes completos

Outros fatores diagnósticos

  • 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
Detalhes completos

Fatores de risco

  • 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
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • Hemograma completo com diferencial
  • testes da função hepática
  • radiografia torácica
  • cultura de escarro
  • hemocultura
Detalhes completos

Investigações a serem consideradas

  • rastreamento de tomografia computadorizada de alta resolução (TCAR)
  • aspirado de medula óssea para cultura
  • broncoscopia/lavagem brônquica
  • biópsia pulmonar
  • biópsia de linfonodos
Detalhes completos

Novos exames

  • reação em cadeia da polimerase

Algoritmo de tratamento

CONTÍNUA

MAC pulmonar

MAC disseminado

Linfadenite por MAC

Pneumonite por hipersensibilidade por MAC

Colaboradores

Autores

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

Declarações

ZT declares that he has no competing interests.

Agradecimentos

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

Declarações

DSA declares that he has no competing interests.

Revisores

Jonathan P. Parsons, MD

Assistant Professor

Division of Pulmonary, Allergy, Critical Care and Sleep Medicine

Ohio State University Medical Center

Columbus

OH

Раскрытие информации

JPP declares that he has no competing interests.

Sandro Vento, MD

Director

Infectious Diseases Unit

Annunziata Hospital

Cosenza

Italy

Раскрытие информации

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.

Список литературы

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Основные статьи

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]Полный текст

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.Полный текст  Аннотация

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.Полный текст  Аннотация

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.Полный текст

Статьи, указанные как источники

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