Viswanath Aishwarya, Manimaran Arjun, Brown Jack, Solano Jhiamluka
Internal Medicine, Scunthorpe General Hospital, Scunthorpe, GBR.
Internal Medicine, Northern Lincolnshire and Goole NHS Trust, Scunthorpe, GBR.
Cureus. 2025 Apr 11;17(4):e82097. doi: 10.7759/cureus.82097. eCollection 2025 Apr.
Non-tuberculous mycobacteria, particularly Mycobacterium avium complex (MAC), have become significant causes of pulmonary infections, especially in immunocompromised individuals. MAC lung disease presents a diagnostic challenge due to its clinical overlap with other pulmonary conditions, including Mycobacterium tuberculosis infections. The need for microbiological confirmation and radiological evaluation complicates early diagnosis. New molecular diagnostic methods, such as PCR, have improved detection but are not universally accessible. Treatment for MAC lung disease typically involves a multidrug regimen including macrolides, rifamycins, and ethambutol. However, the disease often proves resistant to standard therapies, and treatment failure is common due to drug resistance, delayed diagnosis, and poor adherence. Recent research has highlighted the need for personalized treatment strategies and alternative therapies, such as intravenous antibiotics and host-directed treatments, to improve outcomes. The prognosis for MAC lung disease remains poor, especially in patients with preexisting lung conditions like bronchiectasis or rheumatoid arthritis, who are at increased risk of disseminated infection. This case report and review underscore the importance of early recognition and intervention, highlighting the role of a multidisciplinary approach in managing complex infections. Additionally, it emphasizes the need for continued research to identify more effective treatment options and improve patient outcomes in this growing patient population.
非结核分枝杆菌，尤其是鸟分枝杆菌复合群（MAC），已成为肺部感染的重要原因，特别是在免疫功能低下的个体中。MAC肺病因其与包括结核分枝杆菌感染在内的其他肺部疾病存在临床重叠而带来诊断挑战。微生物学确认和放射学评估的需求使早期诊断变得复杂。新的分子诊断方法，如聚合酶链反应（PCR），提高了检测能力，但并非普遍可用。MAC肺病的治疗通常涉及包括大环内酯类、利福霉素和乙胺丁醇的多药方案。然而，该疾病往往对标准疗法耐药，由于耐药性、诊断延迟和依从性差，治疗失败很常见。最近的研究强调了个性化治疗策略和替代疗法的必要性，如静脉内抗生素和宿主导向治疗，以改善治疗效果。MAC肺病的预后仍然很差，尤其是在患有支气管扩张或类风湿性关节炎等既往肺部疾病的患者中，他们发生播散性感染的风险增加。本病例报告及综述强调了早期识别和干预的重要性，突出了多学科方法在管理复杂感染中的作用。此外，它强调了持续研究的必要性，以确定更有效的治疗选择，并改善这一不断增长的患者群体的治疗效果。
