PULMONARY MYCOBACTERIUM-AVIUM COMPLEX DISEASE WITHOUT DISSEMINATION IN HIV-INFECTED PATIENTS

Pulmonary disease due to Mycobacterium avium complex (MAC) without evi dence of dissemination is uncommon in HIV-infected patients. Five case s were observed over a 2-year period. All patients had AIDS and the me dian CD4 cell count at the time of presentation was 90 x 10(6)/L. Radi ographic patterns included unilobar alveolar infiltrates or diffuse al veolar densities. All patients had a favorable clinical response to an timycobacterial chemotherapy with a median follow-up period of 10 mont hs. MAC should be considered in HIV-infected patients with positive re spiratory samples for acid-fast bacilli and pulmonary infiltrates. Pat ients with such findings in whom presumptive therapy for tuberculosis has failed should receive broad-spectrum antimycobacterial chemotherap y until final identification is available.