Mycobacterium-avium-intracellulare complex immune reconstitution inflammatory syndrome in HIV/AIDS presenting as osteomyelitis.
We report a case of osteomyelitis due to Mycobacterium avium-intracellulare complex (MAC) in an AIDS patient shortly after the initiation of antiretroviral therapy with subsequent immune reconstitution inflammatory syndrome (IRIS). He improved after surgical debridement and treatment with clarithromycin, ethambutol, rifabutin, and low-dose corticosteroids. Antiretroviral therapy was not interrupted. MAC should be suspected in IRIS-related complications such as osteomyelitis.
Kahlon
Summerpal S
SS
Melbourne Internal Medicaine Associates, Melbourne, Florida, USA.
East
Jeffrey W
JW
Sarria
Juan C
JC
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use; D004977:Ethambutol / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D015269:Mycobacterium avium Complex / Q000302:isolation & purification; D015270:Mycobacterium avium-intracellulare Infection / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D010019:Osteomyelitis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D017828:Rifabutin / Q000627:therapeutic use; D019562:Viral Load
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D017828:Rifabutin; D004977:Ethambutol; D017291:Clarithromycin