We report the successful treatment of disseminated Mycobacterium intracellulare osteomyelitis, without evidence of other visceral involvement, in a previously healthy, HIV-negative, 2-year-old female using a 23-month regimen of antimicrobial agents that included 18 months of oral therapy with azithromycin, rifabutin, trimethoprimsulfamethoxazole (TMP/SMX), and ethambutol.
Get full access to this article
View all access options for this article.
References
1.
Wallace RJ Jr , O'Brien R., Glassroth J., et al. Diagnosis and treatment of disease caused by nontuberculous mycobacteria (ATS statement). Am Rev Respir Dis.1990;142:940-953.
2.
Benson CA, Ellner JJMycobacterium avium complex infection and AIDS: Advances in theory and practice . Clin Infect Dis.1993;17:7-20.
3.
Ellner JJ, Goldberger MJ, Parenti DMMycobacterium avium infection and AIDS: A therapeutic dilemma in rapid evolution . J Infect Dis. 1991;163:1326-1335.
4.
Starke JRNontuberculous mycobacterial infections in children. Adv Pediatr Infect Dis.1992;7:123-159.
5.
Lincoln EM, Gilbert LADisease in children due to mycobacteria other than Mycobacterium tuberculosis . Am Rev Respir Dis.1972;105:683-714.
6.
Whimbey E., Kiehn TE, Armstrong D.Disseminated Mycobacterium avium-intracellulare disease: diagnosis and therapy . In: Remington JS, Swartz MN, eds. Current Clinical Topics in Infectious Diseases . Vol. 7. New York, NYMcGraw-Hill ; 1980 :112-133.
7.
Bolvig L., Andersen J.Osteomyelitis due to Mycobacterium intracellulare. Pediatr Radiol.1981;10:241-243.
8.
Ellis W.Multiple bone lesions caused by avium-battey mycobacteria: report of a case . J Bone Joint Surg [Br]. 1974 ;56B: 323-326.
9.
Jenkin Djm, Dall G.Lesions of bone in disseminated infection due to the Mycobacterium avium-intracellulare group: report of a case. J Bone Joint Surg [Br]. 1975;57B:373-375.
10.
Collert S., Petrini B., Wickman K Osteomyelitis caused by Mycobacterium avium. Acta Orthop Scand. 1983;54:449-451.
Marchevsky AM, Damsker B., Green S., Tepper S.The clinicopathological spectrum of non-tuberculous mycobacterial osteoarticular infections. J Bone Joint Surg.1985;67A:925-929.
13.
Horsburgh CR Jr, Mason UG III, Farhi DC, Iseman MDDisseminated infection with Mycobacterium avium-intracellulare: A report of 13 cases and a review of the literature . Medicine.1985;64:36-48.
14.
Chin DP, Hopewell PC, Yajko DM, et al. Mycobacterium avium complex in the respiratory or gastrointestinal tract and the risk of M. avium complex bacteremia in patients with human immunodeficiency virus infection. J Infect Dis. 1994;169:289-295.
15.
Iseman MD, Corpe RF, O'Brien RJ,et al. National Consensus Conference on Tuberculosis: disease due to Mycobacterium avium-intracellulare. Chest.1985 ;87:1395-1495.
16.
Heifets LBSynergistic effect of rifampin, streptomycin, ethionamide, and ethambutol on Mycobacterium intracellulare. Am Rev Resp Dis. 1982;125:43-48.
17.
Raszka WV, Skillman LP, McEvoy PLPotential role of trimethoprim-sulfamethoxazole in the treatment of pediatric Mycobacterium avium complex infections. Pediatr Infect Dis.1993;12:418-419. Letter.
18.
Girard AE, Girard D., English AR, et al. Pharmacokinetic and in vivo studies with azithromycin (CP-62,993), a new macrolide with an extended half-life and excellent tissue distribution . Antimicrob Agents Chemother.1987 ;31:1948-1954.
19.
Cynamon MH, Klemens SPActivity of azithromycin against Mycobacterium avium infection in beige mice . Antimicrob Agents Chemother.1992;36:1611-1613.
20.
Young LS, Wiviott L., Wu M., et al. Azithromycin for treatment of Mycobacterium avium-intracellulare complex in patients with AIDS. Lancet. 1991 ;338; 1107-1109.
21.
Gangadharam Prj, Perumal VK, Jairam BT, et al. Activity of rifabutin alone or in combination with clofazimine or ethambutol or both against acute and chronic experimental Mycobacterium intracellulare infections. Am Rev Respir Dis.1987;136:329-333.
22.
Nightingale SD, Cameron DW, Gordin FM, et al. Two controlled trials of rifabutin prophylaxis against Mycobacterium avium complex infection in AIDS. N Engl J Med.1993:329:828-833.
23.
Lewis L., Jacobsen F., Mueller B., et al. A Phase I/II Assessment of Oral Rifabutin Suspension for the Prophylaxis of Mycobacterium Avium Complex (MAC) Bacteremia in HIV-Infected Children. Washington, DC: First National Conference on Human Retroviruses and Related Infections ; Dec 12-16,1993:107. Abstract.
24.
Rastogi N., Goh KS, David HLEnhancement of drug susceptibility of Mycobacterium avium by inhibitors of cell envelope synthesis. Antimicrob Agents Chemother.1990;34:759-764.
25.
Cockerill FR , Edson RSTrimethoprimsulfamethoxazole. Mayo ClinProc.1991; 66:1260-1269.
