How are the dermatologic manifestation of Mycobacterium avium-intracellulare (MAI) infection treated?

Updated: Oct 25, 2019
  • Author: Jaggi Rao, MD, FRCPC; Chief Editor: Dirk M Elston, MD  more...
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Answer

Answer

There is some evidence that BCG vaccination can induce cross immunity to Mycobacterium avium-intracellulare (MAI, or MAC). [28]

Patients hospitalized with MAI (MAC) disease require inpatient care. However, primary cutaneous MAI infection and cervical adenitis may be treated in an outpatient setting if patients are medically compliant.

A standard chemotherapy regimen has not been established for MAI infection because of significant resistance to antimycobacterial drugs. MAI is usually resistant to single-drug therapy and must be treated with multiple antitubercular medications. Sparfloxacin has good antimicrobial activity against several acid-fast bacteria (AFB) and is expected to be an effective drug for treating mycobacteriosis.

MAI infection can be related to infliximab use. [29] MAI/MAC infections have been associated with therapy with brentuximab vedotin. [30]

In cases of cervical adenitis and primary cutaneous MAI infection, follow-up care is required to assess for toxicity due to therapeutic agents and to monitor patients for possible disease recurrence or surgical complications.

Also see Guidelines for the prevention and treatment of opportunistic infections in HIV-exposed and HIV-infected children: recommendations from the National Institutes of Health, Centers for Disease Control and Prevention, the HIV Medicine Association of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the American Academy of Pediatrics. [5]


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