A 70-year-old female presented with chronic productive cough, low grade fever and progressive weight loss for 4 months. Patient had a history of Pulmonary TB 3 years back for which she took ATT for 6 months. The doctor ordered a chest X-ray and a CT to be done. Her sputum sample was taken. Acid fast bacilli were observed. The patient did not respond to the ATT. Some other infection was suspected. Which of the following is the most appropriate regimen to be given in the following condition: -
This is a case of MAC infection (Mycobacterium avium complex infection). Chest x-ray shows hyperinflated lung with extensive bilateral ring shadows consistent with bronchiectasis with upper zone scarring is likely a result of previous TB. CT shows the classical tree-in-bud appearance and B/L bronchiectasis with bronchiolar inflammation, typical of non-tuberculous mycobacterial infection. MAC infection Seen in immunocompromised and patients with underlying lung disease. Patients with an underlying lung disease and history of previous TB - should receive antibiotics. Appropriate regimen is: - Clarithromycin + Ethambutol + Rifabutin x 12 months Pyrazinamide, isoniazid, rifampicin and ethambutol.
Ethambutol + Clarithromycin + Rifabutin
Pyrazinamide + Clarithromycin + Rifabutin
Ethambutol + Clindamycin + Rifabutin
Ethambutol + Clarithromycin + Rifaximin
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