[Mycobacterium avium disease in AIDS patients; diagnosis and therapy]

Ned Tijdschr Geneeskd. 1991 Dec 28;135(52):2485-9.
[Article in Dutch]

Abstract

In eight (25%) of 32 consecutive AIDS patients between 1986 and 1989, Mycobacterium avium infection was diagnosed: in seven disseminated, in one as a local lymph node process. Six patients were treated as consistently as possible with a combination of ethambutol, rifabutine, clofazimine and protionamide (or cycloserine) in relatively large dosages. Median survival of treated patients was 15.5 (4-22) months. Protionamide inhibited most M. avium strains (7 of 8) in vitro, but often caused intolerance (nausea). Treatment of disseminated cytomegalovirus infection in our opinion was necessary in 5 of 6 patients during longterm M. avium therapy. HIV therapy (Zidovudine) during M. avium treatment was not possible due to bone marrow depression. A low maintenance dose of corticosteroids was necessary in 3 of 6 patients (one with adrenal insufficiency) to suppress symptoms such as fever and malaise.

MeSH terms

  • Acquired Immunodeficiency Syndrome / complications*
  • Antitubercular Agents / therapeutic use*
  • Drug Therapy, Combination
  • Humans
  • Mycobacterium avium Complex / isolation & purification
  • Mycobacterium avium-intracellulare Infection / complications*
  • Mycobacterium avium-intracellulare Infection / drug therapy
  • Mycobacterium avium-intracellulare Infection / microbiology

Substances

  • Antitubercular Agents