B20.0
DESCRIPTION
Disseminated infection due to non-tuberculous mycobacteria, usually Mycobacterium avium complex.
Diagnosis must be by culture from sterile sources, e.g. blood, tissue or bone marrow. Note that culture from a single sputum specimen is not adequate to make the diagnosis as this often reflects colonisation rather than disease.
Non-tuberculous mycobacteria can cause limited pulmonary disease, which is diagnosed if the sputum culture is positive repeatedly and there is a worsening pulmonary infiltrate.
Disseminated disease is AIDS-defining (WHO clinical stage 4).
MEDICINE TREATMENT
- Azithromycin, oral, 500 mg daily.
AND
- Ethambutol, oral, 15–20 mg/kg daily.
Treatment can be stopped when treatment has been continued for at least 12 months AND the CD4 count has increased to >100 cells/mm3 on ART.