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In April 2010 we admitted a 26 year old male with HIV/AIDS for evaluation of persistent fever and diarrhea. At his initial diagnosis of HIV in January 2010 his CD4 count was 8 and (HIV) viral load 590,000 copies/ml. He was started on ART therapy in February 2010. Fever evaluation revealed PET scan with left lower lobe lung mass with mediastinal and hilar lymphadenopathy concerning for AIDS related lymphoma, and stool culture stained positive for acid fast bacilli. Viral load on admission was 3200 copies/ml and CD4 count was 131. Lung mass biopsy showed organizing pneumonia with necrotizing granulomas consistent with MAC pneumonia. The biopsy culture and a thoracentesis fluid specimen subsequently grew MAC. Diagnosis of disseminated MAC IRIS was made and the patient was started on four-drug therapy for MAC with continuation of ART.


Presented at the American College of Physicians New Mexico Chapter Scientific Meeting, 10/10, Albuquerque, NM.