We began treatment for presumed Mycobacterium Tuberculosis (MTB)
Isoniazid, rifampin, and pyrazinimide were initiated for presumed MTB.
Prednisone was added to help decrease the size of the nodes. The family
had Mantoux tests, which were all negative.
FINAL DIAGNOSIS
Mycobacterium avium complex: diagnosis was confirmed by cultures of the BAL and biopsy specimen
Follow-up
Immunodeficiency
work-up: negative;
HIV: negative.
Urine for VMA and HVA normal.
The
treatment for MTB was discontinued and she was started on clarithromycin,
rifabutin and ciprofloxacin. After about 8 weeks of therapy with the 3-drug
regimen, she developed neutropenia. The rifabutin was stopped at that
time and she continued on two antibiotics for an additional month and
is to be reevaluated in clinic for ongoing management.
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