Abstract
Introduction: Tuberculosis (TB) and infection, caused by Mycobacterium avium complex (MAC), are the main opportunistic diseases in late presentation of HIV-infection
Aims and Objectives: To determine clinical and laboratory signs of MAC infection to improve the diagnosis and treatment of HIV patients
Methods: Among treated in 2018 in HIV-unit - 9 patients we diagnosed to have MAC infection, 15 - pulmonary TB, 1 - M. kansasii infection. The proportion of MAC and TB was 17 % (24 from 144 admitted patients). Verification of MAC and TB was made by molecular genetic methods and/or culture (MGM/CL)
Results: MGM/CL for MAC was positive from: blood, urine and feces - 5 patients (including 3 in combination with sputum and liquid bronchoalveolar lavage (S/LBAL)) -1st group, S/LBAL solely - 4 patients - 2nd group. All from the 1st group had fever more than 380 Celsius with duration more than 1 month. Among the 2nd group only 1 had fever. Association of fever and positive MGM/CL from blood, urine, feces (1st group substrates) was strong and significant (Pearson contingency coefficient C=0.620, Fisher exact=0.048; p<0.05). This allowed us to describe “the septic form” of MAC disease in HIV patients. 1 patient had MAC infection with hectic temperature, positive MGM from sputum, positive CL from blood, sputum and LBAL, and absence of lung, mediastinal and abdominal lymph node lesions on CT scan
Contrary to MAC TB patients had positive MGM/CL from S/LBAL, lymph node puncture and pleural effusion, but not blood, urine and feces. 8 (53%) were febrile
Conclusion: Febrile HIV late presenters should be suspected for “the septic form” of MAC disease; blood, urine and feces being obligatory tested by MGM/CL
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA4640.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019