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Multidrug Antibiotic Therapy for a Non-Human Immunodeficiency Virus-Infected Patient With Clarithromycin-Resistant Disseminated Mycobacterium avium Complex Disease

The management of macrolide-resistant Mycobacterium avium complex (MAC) disease is challenging. It is extremely rare for non-human immunodeficiency virus (HIV)-infected patients to develop disseminated MAC disease. A 73-year-old non-HIV-infected woman was diagnosed with MAC lung disease (MAC-LD) for...

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Autores principales: Kawamura, Ai, Sugawara, Hitoshi, Fukuchi, Takahiko, Tanaka, Akira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8606041/
https://www.ncbi.nlm.nih.gov/pubmed/34815908
http://dx.doi.org/10.7759/cureus.18967
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author Kawamura, Ai
Sugawara, Hitoshi
Fukuchi, Takahiko
Tanaka, Akira
author_facet Kawamura, Ai
Sugawara, Hitoshi
Fukuchi, Takahiko
Tanaka, Akira
author_sort Kawamura, Ai
collection PubMed
description The management of macrolide-resistant Mycobacterium avium complex (MAC) disease is challenging. It is extremely rare for non-human immunodeficiency virus (HIV)-infected patients to develop disseminated MAC disease. A 73-year-old non-HIV-infected woman was diagnosed with MAC lung disease (MAC-LD) for 20 years and subsequently chronic necrotizing pulmonary aspergillosis for three years. To avoid drug interaction between rifampicin and voriconazole, MAC-LD was treated with clarithromycin (CLR) alone. The results of the bone biopsy and bone marrow culture conducted for back pain were compatible with CLR-resistant MAC vertebral osteomyelitis. The clinical management of CLR-resistant disseminated MAC disease consisting of lung and spinal lesions with no established treatment and a poor prognosis is challenging. In this case, the patient was treated with multidrug antibiotic therapy, including CLR, ethambutol, rifampicin, amikacin, and moxifloxacin. The results show the effectiveness of multidrug antibiotic therapy in treating CLR-resistant disseminated MAC disease.
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spelling pubmed-86060412021-11-22 Multidrug Antibiotic Therapy for a Non-Human Immunodeficiency Virus-Infected Patient With Clarithromycin-Resistant Disseminated Mycobacterium avium Complex Disease Kawamura, Ai Sugawara, Hitoshi Fukuchi, Takahiko Tanaka, Akira Cureus Infectious Disease The management of macrolide-resistant Mycobacterium avium complex (MAC) disease is challenging. It is extremely rare for non-human immunodeficiency virus (HIV)-infected patients to develop disseminated MAC disease. A 73-year-old non-HIV-infected woman was diagnosed with MAC lung disease (MAC-LD) for 20 years and subsequently chronic necrotizing pulmonary aspergillosis for three years. To avoid drug interaction between rifampicin and voriconazole, MAC-LD was treated with clarithromycin (CLR) alone. The results of the bone biopsy and bone marrow culture conducted for back pain were compatible with CLR-resistant MAC vertebral osteomyelitis. The clinical management of CLR-resistant disseminated MAC disease consisting of lung and spinal lesions with no established treatment and a poor prognosis is challenging. In this case, the patient was treated with multidrug antibiotic therapy, including CLR, ethambutol, rifampicin, amikacin, and moxifloxacin. The results show the effectiveness of multidrug antibiotic therapy in treating CLR-resistant disseminated MAC disease. Cureus 2021-10-22 /pmc/articles/PMC8606041/ /pubmed/34815908 http://dx.doi.org/10.7759/cureus.18967 Text en Copyright © 2021, Kawamura et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Infectious Disease
Kawamura, Ai
Sugawara, Hitoshi
Fukuchi, Takahiko
Tanaka, Akira
Multidrug Antibiotic Therapy for a Non-Human Immunodeficiency Virus-Infected Patient With Clarithromycin-Resistant Disseminated Mycobacterium avium Complex Disease
title Multidrug Antibiotic Therapy for a Non-Human Immunodeficiency Virus-Infected Patient With Clarithromycin-Resistant Disseminated Mycobacterium avium Complex Disease
title_full Multidrug Antibiotic Therapy for a Non-Human Immunodeficiency Virus-Infected Patient With Clarithromycin-Resistant Disseminated Mycobacterium avium Complex Disease
title_fullStr Multidrug Antibiotic Therapy for a Non-Human Immunodeficiency Virus-Infected Patient With Clarithromycin-Resistant Disseminated Mycobacterium avium Complex Disease
title_full_unstemmed Multidrug Antibiotic Therapy for a Non-Human Immunodeficiency Virus-Infected Patient With Clarithromycin-Resistant Disseminated Mycobacterium avium Complex Disease
title_short Multidrug Antibiotic Therapy for a Non-Human Immunodeficiency Virus-Infected Patient With Clarithromycin-Resistant Disseminated Mycobacterium avium Complex Disease
title_sort multidrug antibiotic therapy for a non-human immunodeficiency virus-infected patient with clarithromycin-resistant disseminated mycobacterium avium complex disease
topic Infectious Disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8606041/
https://www.ncbi.nlm.nih.gov/pubmed/34815908
http://dx.doi.org/10.7759/cureus.18967
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