MAC lung disease (MAC) was identified in the late 1800s and today still affects many people over the age of 50. It often affects those who have AIDS or low immune system function. However, MAC lung disease is not contagious but is normally spread through germs entering through bronchial passages.
MAC is a bacteria called Mycobacterium avium intracellulare. It is a micro-organism similar to the germs that cause tuberculosis. The difference is that this organism is not contagious and the microbes live in the environment. This germ causes two different types of lung diseases known as nodular disease and upper-lobe cavitary disease. Nodular disease takes place in the multiple nodules in the lungs and the upper-lobe cavitary disease appears in the cavities of the upper parts of the lung and mimics tuberculosis.
MAC lung disease can cause significant weight loss, severe diarrhea, coughing, difficulty breathing, exhaustion, chest pain or discomfort, fever, and sometimes coughing or spitting up blood.
Conditions that play a factor in contracting MAC lung disease are patients who have scoliosis, reflux disorders, asthma, chronic bronchitis, cystic fibrosis and lung issues. The risk increases for those over the age of 50 who are heavy smokers and drink alcohol in excess.
Treatment options for this condition include a four-drug regimen. This regimen consists of clarithromycin, azithromax, ethambutol and rifabutin. For those with severe cases, additional drugs might be administered via intramuscular shots or intravenous fusion for faster results. However, the usual treatment lasts anywhere from 15 to 18 months because getting the medications into the lungs to treat the germ is quite difficult. Patients who have failed to recover using this regimen are then progressed to the next line of treatment which includes amikacin via nebulizer, ciprofloxacin, mefloquin, clofazimine, ethionamide and cycloserine. Because of the toxicity of the last two medications, only a health care professional with vast experience in MAC, should distribute, prescribe or recommend these.
Comfort measures for patients with MAC include regular exercise such as walking, yoga, Pilates and strength training are highly recommended. In patients with MAC, more effort is required because of the fatigue associated with this disease. Proper nutrition and adequate calorie intake is essential. A patient suffering from MAC needs to keep his weight stable or even gain weight to help him keep active. Healthy and regular rest and sleep periods will help with fatigue. Assistance with household chores such as cooking and cleaning are sometimes necessary as well as help to ease anxiety. Counseling is helpful in dealing with emotional issues that arise due to living with a chronic illness. Joining a MAC support group will provide much needed support and information for those dealing with this condition.
According to the aids.org, approximately 50 percent of those with AIDS will develop MAC lung disease. Those who have a CD4 count that is below 50 are more susceptible to developing MAC.