Two cases of long lasting bacteremia due to Mycobacetrium avium complex despite new macrolides-containing regimens in patients with acquired immunodeficiency syndrome

Abstract

The prognosis of Mycobacterium avium complex (MAC) infection has been improved by new macrolidescontaining regimens and the use of highly active antiretroviral therapy (HAART) in the treatment of acquired immunodeficiency syndrome (AIDS). We report on two AIDS cases with long lasting bacteremia due to MAC under this regimen. Both patients experienced problems due to side effects from the anti-MAC regimen and from an immunereconstitution syndrome related to HAART. MAC infection persisted despite treatment, however, no anti-MAC drug-resistant isolates emerged throughout the clinical course in either case. These cases demonstrate that therapy for disseminated MAC infection is sometimes difficult even with HAART and macrolides-containing regimens.