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Mycobacterium avium-intracellulare: Another Scourge for Individuals With the Acquired Immunodeficiency Syndrome

Henry Masur, MD
JAMA. 1982;248(22):3013. doi:10.1001/jama.1982.03330220057039.
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The Mycobacterium avium-intracellulare complex (MAC) is a commonly encountered group of environmental contaminants that are recognized to cause localized lung disease, particularly in persons in the southeastern United States who have preexisting lung disease. The rarity of human MAC disease has indicated that these organisms are relatively avirulent, yet it is hardly surprising that a few immunosuppressed adults (about 14) and children (about 18) have been described during the years to have had disseminated MAC disease. In this issue, Zakowski and colleagues (p 2980) verified the occurrence of disseminated disease in five homosexual males with acquired immunodeficiency (AID) syndrome, all recognized within a nine-month period at one institution. This sudden occurrence of five cases in conjunction with similar observations from several other institutions raises intriguing questions about the epidemiology and pathogenicity of MAC.1

The MAC is present in dust, dirt, fresh water, ocean water, and animal feed.2 These


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