Abdominal symptoms are prominent in disseminated Mycobacterium avium complex (MAC) infection. They include diarrhea, abdominal pain,
nausea, vomiting, and hepatosplenomegaly.1,2 We describe a patient with disseminated MAC infection who
had perforating appendicitis due to MAC.
Report of a Case. A 36-year-old homosexual man with
acquired immunodeficiency syndrome (AIDS) presented for evaluation of a 4-day history of diffuse colicky pain, later located in the right lower quadrant of the
abdomen. Two months earlier MAC organisms had been
isolated from blood cultures, and the patient was receiving clarithromycin, ethambutol hydrochloride, ciprofloxacin hydrochloride, and clofazamine. His most recent CD4 cell count had been 0.03×109/L. Physical
examination revealed an axillar temperature of 36.6°C
(rectal temperature, 38°C), mild abdominal distention
with hepatosplenomegaly, absence of bowel sounds, diffuse abdominal tenderness, and a positive psoas sign. The
white blood cell count was elevated over baseline at
3.2×107L, with 0.74 neutrophils and 0.18 band cell
forms. An x-ray
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