title: Mycobacterium-avium-intracellulare complex immune reconstitution inflammatory syndrome in HIV/AIDS presenting as osteomyelitis.
abstract: 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.
authors.affiliation: Melbourne Internal Medicaine Associates, Melbourne, Florida, USA.
authors.forename: Summerpal S
authors.initials: SS
authors.lastname: Kahlon
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: East
authors.forename: Juan C
authors.initials: JC
authors.lastname: Sarria
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D017828:Rifabutin; D004977:Ethambutol; D017291:Clarithromycin