What is the prevalence of dermatologic manifestations of Mycobacterium avium-intracellulare (MAI) infection?

Updated: May 27, 2021
  • Author: Jaggi Rao, MD, FRCPC; Chief Editor: Dirk M Elston, MD  more...
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Answer

In the United States, Mycobacterium avium-intracellulare (MAI, or MAC) infection is considered a nonreportable infectious disease. The US Centers for Disease Control and Prevention (CDC) surveillance data from Houston and Atlanta suggest an incidence of 1 case per 100,000 persons per year. The incidence of disseminated MAI (DMAI) peaked in 1994 at 37,000 cases, coinciding with height of the acquired immunodeficiency syndrome (AIDS) epidemic. This coincidence concords with the fact that DMAI infection often occurs in association with HIV disease. One case series revealed cutaneous involvement in 6 of 30 cases of DMAI infection. CDC data also suggest that the incidence of MAI infection may be decreasing as a result of highly active antiretroviral therapy and antimicrobial prophylaxis. [5, 6]

Primary cutaneous MAI infection is rare, with 12 cases reported in the literature prior to 1997. This condition has been reported in all age groups; although most case reports of primary cutaneous MAI infection have been in individuals aged 2-10 years, adult cases have also been described. A review of 8 cases of cutaneous MAI infection occurring secondary to disseminated disease found a median patient age of 22.2 years, with a range of 2-28 years. Another review from 2018 of 30 cases of cutaneous MAI reported an average age of 44.2 years, with a range of 4-82 years. Of these, 8 patients were younger than 18 years. [1]

The degree to which skin involvement occurs as a sequela of cervical adenitis has not been well studied; however, the literature suggests that the risk of skin involvement increases with advanced disease. Cervical adenitis most commonly affects children. One chart review series of 47 children with cervical adenitis revealed a median age of 3 years at the time of MAI infection diagnosis. [7]


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