Johnson Jessica, Driscoll Meghan, Cohen Michael, Adler Douglas G
Department of Gastroenterology and Hepatology, University of Utah School of Medicine, Salt Lake City, UT.
Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT.
ACG Case Rep J. 2016 Jul 27;3(4):e92. doi: 10.14309/crj.2016.65. eCollection 2016 Aug.
intracellulare complex (MAC) is an opportunistic infection typically associated with profound immunosuppression, such as AIDS. The presentation of disseminated MAC can be subtle and mimic systemic symptoms associated with lymphoma; abdominal pseudotumor is an exceptionally rare presentation. In the era of highly active anti-retroviral therapy (HAART), opportunistic infections are increasingly rare, and secondary prophylaxis for MAC may be discontinued after adequate therapy and immune reconstitution. Recurrence of disseminated MAC after adequate therapy may be due to macrolide resistance, but with an adequate CD4 T-cell count and undetectable HIV viral load, recurrence raises questions of more subtle immune dysregulation.
鸟分枝杆菌复合体(MAC)是一种机会性感染,通常与严重免疫抑制相关,如艾滋病。播散性MAC的表现可能不明显,并可模仿与淋巴瘤相关的全身症状;腹部假瘤是一种极其罕见的表现。在高效抗逆转录病毒治疗(HAART)时代,机会性感染越来越少见,充分治疗和免疫重建后可停用MAC的二级预防。充分治疗后播散性MAC复发可能是由于对大环内酯类耐药,但在CD4 T细胞计数充足且HIV病毒载量不可检测的情况下,复发引发了关于更细微免疫失调的问题。