Microcheck 293

Infectious diseases are a major threat to individuals with immunodeficiency. They get the same infectious diseases as healthy people, and in addition, they are much more susceptible to reactivation of latent infections, and organisms of low virulence generally harmless to others. Prevention of infectious diseases in AIDS patients is key to improving the quality and duration of their lives.

■ Bacteria, fungi, protozoa, and viruses can all cause life-threatening diseases in AIDS patients. Name a fifth kind of infectious agent that can do the same.

■ The disease pneumocystosis mainly involves which part of the body?

■ Why should raw or uncooked meat not be eaten?

Table 29.10

MAC Disease

Symptoms

Usually asymptomatic in healthy people. Children can develop chronic localized enlargement of lymph nodes. Can cause chronic cough similar to tuberculosis in the elderly. Cough, fever, sweating, marked weight loss, abdominal pain, and diarrhea in those with severe immunodeficiencies

Incubation period

Usually indeterminate

Causative agents

A group of mycobacterial strains in the species M. avium and M. intracellulars

Pathogenesis

MAC bacteria enter the body via lungs or gastrointestinal tract, are taken up by macrophages. In immunocompetent individuals, most are destroyed and infection controlled by cellular immunity. In severe immunodeficiency the bacteria multiply without restraint, are carried by macrophages throughout the body, and grow to enormous numbers in tissues but cause little or no inflammatory reaction

Epidemiology

MAC organisms are widespread in food, water, soil, and dust. MAC disease of immunodeficient persons could result from environmental sources, or activation of latent infection

Prevention and treatment

No proven measures to prevent exposure to MAC bacteria.The antibiotic clarithromycin is used to prevent MAC disease in severe immunodeficiency. If MAC bacteremia develops, two or more medications, such as clarithromycin plus ethambutal, are effective

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