Infection Due to Nontuberculous Mycobacterium Other
than MAC in AIDS Patients at Siriraj Hospital During
1998-2000 : Saprophyte vs Pathogen
WINAI RATANASUWAN, M.D.*, THANOMSAK ANEKTHANANONT, M.D.*,
WICHAI TECHASATHIT, M.D.*, JUREE JEARANAISILAVONG, M.Sc.**,
VARAPORN CHUENAROM, B.N.*, ANGKANA CHAIPRASERT, Dr.rernat**,
SURAPOL SUWANAGOOL, M.D.*
Affiliation : * Department of Preventive and Social Medicine,
** Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
AbstractHIV is a major health problem in Thailand. These patients are vulnerable to opportunistic
infections, especially Mycobacterium tuberculosis and MAC infection. However, NTM was con
sidered a rare disease in Thailand before the AIDS era. In this study, there were 38 HIV seropositive
patients with NTM (other than MAC) identified from clinical specimens during the 3 year period
1998-2000 at Siriraj Hospital, which has a higher prevalence than the previous report. Among these
patients, 29 cases were likely to have had definite infection from NTM, 5 cases possibly had NTM
as a pathogen, and 4 cases had NTM as colonization. The most common site of infection was the
lung (87%) and most common symptoms were cough (62.2%), fever (34.2%), weight loss (42.1%),
and lymphadenopathy (5.3%). The outcome was poor because many NTM are not susceptible to
standard medication for tuberculosis which is the empirical treatment for the majority of HIV sero
positive patients with a clinical finding suspected of mycobacterial infection. The fatality rate was as
high as 58.6 per cent. Awareness of NTM as a potential pathogen in HIV seropositive patients and
adjustment of medications even before the availability of culture results may improve the outcome
of treatment of NTM infection in HIV seropositive patients.
Keywords : Key word Non-Tuberculous Mycobacterial Infection, Acquired Immunodeficiency Syndrome,
Thailand
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