SUCCESSFUL TREATMENT OF MENINGOENCEPHALITIS CAUSED BY MYCOBACTERIUM-AVIUM-INTRACELLULARE IN AIDS

A wide variety of pathologies afflicting the CNS is see in patients in fected with the human immunodeficiency virus. We report the case of re lapsing meningoencephalitis caused by Mycobacterium avium intracellula re (MAI) in a homosexual male with the acquired immunodeficiency syndr ome in whom repeated use of polymerase chain reaction was required to detect MAI-specific DNA in the cerebrospinal fluid. Successful respons es to early empirical antibiotic combination treatment, including the drugs clarithromycin and rifabutin, were demonstrated by clinical, EEG , and CSF improvement during an 8-month period. To our knowledge, this study presents the first known patient with the acquired immunodefici ency syndrome effectively treated for MAI meningoencephalitis and sugg ests that modern antimycobacterial combination therapy may improve the poor prognosis of CNS infections with nontuberculous mycobacteria.