Dx: Anemia, ↑ Alk Phos, ↑ LDH. AFB smear and blood culture are key.
Tx: Clarithromycin or Azithromycin + Ethambutol. Rifabutin often added.
Prophylaxis: Azithromycin weekly for HIV pts with CD4 < 50.
Pulmonary Disease (Immunocompetent)
Presents similarly to TB (cough, fatigue, hemoptysis).
Can cause cavitary lesions, often in pts with underlying COPD.
“Lady Windermere Syndrome”: Bronchiectasis and nodular infiltrates in the R middle lobe/lingula, classically in elderly, thin women who chronically suppress their cough reflex.
M. marinum
Fish tank granuloma: skin infection usually of the hand that occur in individuals handling fish (e.g., aquarium handlers)