Mycobacterium avium-Complex Infections and Immunodeficiency

  • Frank M. Collins
Part of the Infectious Agents and Pathogenesis book series (IAPA)


The atypical mycobacteria constitute a diverse and heterogeneous group of acid-fast bacilli that are widespread in distribution throughout the natural environment.1 They also include a number of important opportunistic human and animal pathogens.2 Most organisms in this group are not considered pathogenic for immunocompetent adults, although they do occasionally establish residence within normal tissues, where they give rise to persistent infections that can be difficult to eliminate, due to their high resistance to most antituberculosis drugs.3 Such systemic infections are usually associated with some other underlying disease, such as silicosis, emphysema, or Hodgkin disease. A few species (e.g., M. kansasii, M. avium, and M. ulcerans) are considered overt human pathogens, causing progressive pathologic changes within the infected tissues.4 Although most cases of pulmonary tuberculosis are caused by M. tuberculosis, small numbers of M. kansasii and M. avium infections are reported each year. When combined, these pathogens are responsible for at least 2 million deaths worldwide each year,5 with the atypical mycobacterial infections constituting perhaps 5% of the total patient population.6 These organisms are generally considered much less virulent for humans than M. tuberculosis,7 although recently they have become a matter for concern due to the increasing acquired immunodeficiency syndrome (AIDS) epidemic.8


Acquire Immune Deficiency Syndrome Acquire Immunodeficiency Syndrome Mycobacterial Infection Nontuberculous Mycobacterium Acquire Immune Deficiency Syndrome Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Barksdale, L., and Kim, K-S., 1977, Mycobacterium, Bacteriol. Rev. 41:217–372.PubMedGoogle Scholar
  2. 2.
    Wolinsky, E., 1979, Nontuberculous mycobacteria and associated diseases, Am. Rev. Respir. Dis. 119:107–159.PubMedGoogle Scholar
  3. 3.
    Davidson, P. T., 1979, The management of disease with atypical mycobacteria, Clin. Notes Respir. Dis. 18:3–13.PubMedGoogle Scholar
  4. 4.
    Chapman, J. S., 1982, The atypical mycobacteria, Am. Rev. Respir. Dis. 125:S119–124.Google Scholar
  5. 5.
    Anonymous, 1982, Centennial: Koch’s discovery of the tubercle bacillus, M.M.W.R. 31:121–123.Google Scholar
  6. 6.
    Farer, L. S., Lowell, A. M. ,and Meador, M. P., 1979, Extrapulmonary tuberculosis in the United States, Am. J. Epidemiol. 109:205–267.PubMedGoogle Scholar
  7. 7.
    Robakiewicz, M., and Grzybowski, S., 1974, Epidemiological aspects of nontuberculous mycobacterial disease and of tuberculosis in British Columbia, Am. Rev. Respir. Dis. 109:613–620.PubMedGoogle Scholar
  8. 8.
    Anonymous, 1986, Tuberculosis-United States, 1985-and the possible impact of human T-lymphotrophic virus type III/Lymphadenopathy-associated virus infection, M.M.W.R. 35:74–76.Google Scholar
  9. 9.
    Schaefer, W. F., 1979, Serological identification of atypical mycobacteria, Methods Microbiol. 13:323–343.CrossRefGoogle Scholar
  10. 10.
    McClatchy, J. K., 1981, The seroagglutination test in the study of nontuberculous mycobacteria, Rev. Infect. Dis. 3:867–870.PubMedCrossRefGoogle Scholar
  11. 11.
    Thoen, C. O., Himes, E. M., and Karlson, A. G., 1984, Mycobacterium avium complex, Microbiol. Series 15:1251–1275.Google Scholar
  12. 12.
    Anonymous, 1981, Diagnostic standards and classification of tuberculosis and other mycobacterial diseases, Am. Rev. Respir. Dis. 123:343–358.Google Scholar
  13. 13.
    Chapman, J. S., 1971, The ecology of the atypical mycobacteria, Arch. Environ. Health 22:41–46.PubMedGoogle Scholar
  14. 14.
    Gruft, H., Katz, J., and Blanchard, D. C., 1975, Postulated source of M. intracellular (Battey) infection, Am. J. Epidemiol. 102:311–318.PubMedGoogle Scholar
  15. 15.
    Meissner, G., and Anz, W.. 1977, Sources of M. avium-complex infection resulting in human disease, Am. Rev. Respir. Dis. 116:1057–1064.PubMedGoogle Scholar
  16. 16.
    Comstock, G. W., 1982, Epidemiology of tuberculosis, Am. Rev. Respir. Dis. 125:S8– 15.Google Scholar
  17. 17.
    Anonymous, 1972, What needs to be done to eradicate tuberculosis, Am. J. Public Health 62:127–128.CrossRefGoogle Scholar
  18. 18.
    Anonymous, 1985, Tuberculosis-United States 1984, MMWR 34:299–307.Google Scholar
  19. 19.
    Collins, F. M. ,1982, The immunology of tuberculosis, Am. Rev. Respir. Dis. 125:S42– 49.Google Scholar
  20. 20.
    Timpe, A., and Runyon, E. H. ,1954, Relationship of “atypical” acid-fast bacilli to human disease, J. Lab. Clin. Med. 44:202–209.PubMedGoogle Scholar
  21. 21.
    Wayne, L. G. ,1984, Mycobacterial speciation, Microbiol. Ser: 15:25–65.Google Scholar
  22. 22.
    Runyon, E. H. ,Karlson, A. G. ,Kubica, G. P., and Wayne, L. G., 1974, Mycobacterium, in Manual of Clinical Microbiology ,2nd ed. (E. H. Lennette, E. H. Spaulding, J. P. Truant, eds.), pp. 148–174, American Society of Microbiology, Washington, D.C.Google Scholar
  23. 23.
    Edwards, L. B., and Palmer, C. E., 1959, Isolation of “atypical” mycobacteria from healthy persons, Am. Rev. Respir. Dis. 80:747–749.PubMedGoogle Scholar
  24. 24.
    Atwell, R. J., and Pratt, P. C., 1960, Unclassified mycobacteria in gastric contents of healthy personnel and patients of tuberculosis hospital, Am. Rev. Respir. Dis. 81:888– 892.PubMedGoogle Scholar
  25. 25.
    Tsukamura, M., 1973, Background factors for casual isolation of M. intracellulare from patients with tuberculosis, Am. Rev. Respir. Dis. 108:679–683.PubMedGoogle Scholar
  26. 26.
    Wolinsky, E., 1981, Editorial. When is an infection disease?, Rev. Infect. Dis. 3:1025– 1027.PubMedCrossRefGoogle Scholar
  27. 27.
    Edwards, L. B., Acquaviva. F. A. ,Livesay, V. T., Cross, F. W., and Palmer, C. E., 1969, An atlas of sensitivity to tuberculin, PPD-B and histoplasmin in the United States, Am. Rev. Respir. Dis. 99: SI-132.Google Scholar
  28. 28.
    Rosenzweig, D. Y. ,1979, Pulmonary mycobacterial infections due to Mycobacterium intracellular-avium complex, Chest 75:115–119.PubMedCrossRefGoogle Scholar
  29. 29.
    Snider, D. E., 1982, The tuberculin skin test, Am. Rev. Respir. Dis. 125:S108–118.Google Scholar
  30. 30.
    Anonymous, 1966, Further studies of acquired sensitivity to human and avian tuberculins at successive tests in school children, Tubercle 47:157–177.CrossRefGoogle Scholar
  31. 31.
    Good, R. C., 1980, Isolation of nontuberculous mycobacteria in the United States, 1979. J. Infect. Dis. 142:779–783.CrossRefGoogle Scholar
  32. 32.
    Good, R. C., and Snider, D. E., 1982, Isolation of non-tuberculous mycobacteria in the United States, 1980, J. Infect. Dis. 146:829–833.CrossRefGoogle Scholar
  33. 33.
    Goslee, S., and Wolinsky, E., 1976, Water as a source of potentially pathogenic mycobacteria, Am. Rev. Respir. Dis. 113:287–292.PubMedGoogle Scholar
  34. 34.
    Falkinham, J. O., Parker, B. C., and Gruft, H., 1980, Epidemiology of infection by nontuberculous mycobacteria. 1. Geographic distribution in the Eastern United States, Am. Rev. Respir. Dis. 121:931–937.PubMedGoogle Scholar
  35. 35.
    Saitz, E. W., 1981, Cervical lymphadenitis caused by atypical mycobacteria, Pediatr. Clin. North Am. 28:823–839.PubMedGoogle Scholar
  36. 36.
    Damsker, B., and Bottone, E. J., 1985, Mycobacterium avium-M. intracellulare from the intestinal tracts of patients with acquired immunodeficiency syndrome: Concepts regarding acquisition and pathogenesis, J. Infect. Dis. 151, 179–181.PubMedCrossRefGoogle Scholar
  37. 37.
    Collins, F. M., 1986, M. avium-complex infections and development of the acquired immunodeficiency syndrome: Casual opportunist or causal cofactor?, Int. J. Lepr. 54:458–474.Google Scholar
  38. 38.
    Jenkins, P. A., 1981, Nontuberculous mycobacteria and disease, Eur. J. Respir. Dis. 62:69–71.PubMedGoogle Scholar
  39. 39.
    Horsburg, C. R., Mason, V. G., Farlin, D. C., and Iseman, M. D., 1985, Disseminated infection with M. avium-intracellular e: A report of 13 cases and a review of the literature, Medicine (Baltimore) 64:36–48.Google Scholar
  40. 40.
    Fischer, D. A., Lester, W., and Schaefer, W. B., 1968, Infections with atypical mycobacteria. Five years experience at the National Jewish Hospital, Am. Rev. Respir. Dis. 98:29–34.PubMedGoogle Scholar
  41. 41.
    Rosenzweig, D. Y., and Schlueter, D. P., 1981, Spectrum of clinical disease in pulmonary infection with M. avium-intracellulare, Rev. Infect. Dis. 3:1046–1051.PubMedCrossRefGoogle Scholar
  42. 42.
    Ahn, C. H., Lowell, J. R., Onstad, G. D., Shurford, E. H., and Hurst, G. A., 1979, A demographic study of disease due to M. kansasii or M. intracellulare-avium in Texas, Chest 75:120–125.PubMedCrossRefGoogle Scholar
  43. 43.
    Codias, E. K., and Reinhardt, D. J., 1979, Distribution of serotypes of the M. avium-intracellulare-scrofulaceum complex in Georgia, Am. Rev. Respir. Dis. 119:965–970.PubMedGoogle Scholar
  44. 44.
    Wiesnethal, A. M., Powell, K. E., Kopp, J., and Splinter, J. W., 1982, Increase in M: avium-complex isolates among patients admitted to a general hospital, Public Health Rep. 97:61–65.Google Scholar
  45. 45.
    Lincoln, E. M. ,and Gilbert, L. A., 1972, Disease in children due to mycobacteria other than M. tuberculosis, Am. Rev. Respir. Dis. 105:683–714.PubMedGoogle Scholar
  46. 46.
    Yeager, H., and Raleigh, J. W., 1973, Pulmonary disease due to M. intracellular, Am. Rev. Respir. Dis. 108:547–552.PubMedGoogle Scholar
  47. 47.
    Cook, P. L., Riddell, R. W.. and Simon, G., 1971, Bacteriological and radiographic features of lung infection by opportunist mycobacteria: A review, Tubercle 52:232– 241.PubMedCrossRefGoogle Scholar
  48. 48.
    Schaefer, W. B., Davis, C. L., and Cohn, M. L., 1970, Pathogenicity of translucent, opaque and rough variants of M. avium in chickens and mice, Am. Rev. Respir. Dis. 123:343–358.Google Scholar
  49. 49.
    Watson, S. R., Morrison, N. E., and Collins, F. M., 1979, Delayed hypersensitivity responses in mice and guinea pigs to M. leprae, M. vaccae and M. nonchromogenicum cytoplasmic proteins. Infect. Immun. 25:229–236.PubMedGoogle Scholar
  50. 50.
    Moehring, J. M.. and Soloterovsky, M. R., 1965, Relationship of colonial morphology to virulence for chickens of M. avium and the nonphotochromogens, Am. Rev. Respir. Dis. 92:704–713.PubMedGoogle Scholar
  51. 51.
    Moulding, T., 1978, The relative drug-susceptibility of opaque colonial forms of M. intracellulare-avium: Does it affect therapeutic results?, Am. Rev. Respir. Dis. 117: 1142– 1143.PubMedGoogle Scholar
  52. 52.
    Collins, F. M., Morrison, N. E., and Montalbine, V., 1978, Immune response to persistent mycobacterial infection in mice. Infect. Immun. 19:430–438.Google Scholar
  53. 53.
    Collins, F. M., and Stokes, R. W., 1987, M. aimzra-complex infections in normal and immunosuppressed mice, Tubercle 68: 127–136.PubMedCrossRefGoogle Scholar
  54. 54.
    Collins, F. M., 1979, Cellular antimicrobial immunity, CRC Crit. Rev. Microbiol. 7:27– 91.CrossRefGoogle Scholar
  55. 55.
    Hepper, K. P., and Collins, F. M., 1984, Immune responsiveness in mice heavily infected with M. kansasii, Immunology 53:357–364.PubMedGoogle Scholar
  56. 56.
    Kantor, F. S., 1975, Infection, anergy and cell-mediated immunity, N. Engl. J. Med. 292:629–634.PubMedCrossRefGoogle Scholar
  57. 57.
    Fine, P. E. M., 1981, Immunogenetics of susceptibility to leprosy, tuberculosis and leishmaniasis. An epidemiological perspective, Int. J. Lepr. 49:437–454.Google Scholar
  58. 58.
    Jakab, G. J. ,1981, Interactions between Sendai virus and bacterial pathogens in the murine lung: A review, Lab. Anim. Sci. 31:170–177.PubMedGoogle Scholar
  59. 59.
    Bailey, W. C., Brown, M. Beuchner, H. A., 1974, Silico-mycobacterial disease in sandblasters, Am. Rev. Respir. Dis. 110:115–125.PubMedGoogle Scholar
  60. 60.
    Schepers, G. W., Smart, R. H., Smith, C. R., et al. ,1958, Fatal silicosis with complicating infection by an atypical acid-fast photochromogenic bacillus. Indust. Med. Surg. 27:27–32.Google Scholar
  61. 61.
    Allison, A. C., and Hart, P. D., 1968, Potentiation of the growth of M. tuberculosis in macrophage cultures, Br. J. Exp. Pathol. 49:465–476.PubMedGoogle Scholar
  62. 62.
    Steenken, W., Raleigh, J. W., and Smith, M. M. ,1964, Pathogenicity of attenuated and avirulent tubercle bacilli, Lancet 1:85–88.Google Scholar
  63. 63.
    Comstock, G. W., 1975, Frost revisited: The modern epidemiology of tuberculosis, Am. J. Epidemiol. 101:363–382.PubMedGoogle Scholar
  64. 64.
    Anonymous, 1983, Tuberculosis in old age. Tubercle 64:69–71.CrossRefGoogle Scholar
  65. 65.
    Andrew, O. T., Schoenfeld, P. Y., Hopewell, P. C., and Humphreys, M. H., 1980, Tuberculosis in patients with end-stage renal disease, Am. J. Med. 68:59–65.PubMedCrossRefGoogle Scholar
  66. 66.
    Fraser, D. W., Buxton, A. E., Naji, A., Barker, C. F., Rudnick, M., and Weinstein, 1975, Disseminated M. kansasii infection presenting as cellulitis in a recipient of a renal graft, Am. Rev. Respir. Dis. 112: 125–129.PubMedGoogle Scholar
  67. 67.
    Abbott, M. R., and Smith, D. D., 1981, Mycobacterial infections in immunosup-pressed patients, Med. J. Aust. 1:351–353.PubMedGoogle Scholar
  68. 68.
    Millar, J. W., and Home, N. W., 1979. Tuberculosis in immunosuppressed patients, Lancet 1: 1176–1178.PubMedCrossRefGoogle Scholar
  69. 69.
    Dannenberg, A. M., 1984, Chemical and enzymatic host factors in resistance to tuberculosis, Microbiol. Ser. 15:721–760.Google Scholar
  70. 70.
    McCune, R. M., Feldman. F. M., Lambert, H. P., and McDermott, W., 1966, Microbial persistence. 1. The capacity of tubercle bacilli to survive sterilization in mouse tissues, J. Exp. Med. 123:455–468.Google Scholar
  71. 71.
    Dannenberg, A. M., 1979, The anti-inflammatory effects of glucocorticosteroids: A brief review of the literature, Inflammation 3:329–343.PubMedCrossRefGoogle Scholar
  72. 72.
    Kasik, J. E., Monick, M., and Thompsen, J. S., 1976, Immunosuppressant activity of the ansamycins, Antimicrob. Agents Chemother. 9:430–473.Google Scholar
  73. 73.
    Fauci, A. S., 1984, Acquired immunodeficiency syndrome: Epidemiologic, immunologic and therapeutic considerations, Ann. Intern. Med. 100:92–106.PubMedGoogle Scholar
  74. 74.
    Feld, R., Bodey, G. P., and Groschel, D., 1976, Mycobacteriosis in patients with malignant disease, Arch. Intern. Med. 136:67–70.PubMedCrossRefGoogle Scholar
  75. 75.
    Ortbals, D., and Marr, J.. 1978, A comparative study of tuberculosis and other mycobacterial infections and their association with malignancy, Am. Rev. Respir. Dis. 117:39–45.PubMedGoogle Scholar
  76. 76.
    Kiehn, T. E., Edwards, F. F., Brannon, P., Tsang A., Maio, M., Gold, J., Whinbeg, E., Wang, B., McClatchy, J. K., and Armstrong, D., 1985, Infections caused by M. avium- complex in immunocompromised patients: Diagnosis by blood culture and fecal examination, antimicrobial susceptibility test and morphological and serological characteristics, J. Clin. Microbiol. 21:168–173.PubMedGoogle Scholar
  77. 77.
    McGeady, S. J. ,and Murphey, S. A. ,1981, Disseminated M. kansasii infection, Clin. Immunol. Immunopathol. 20:87–98.PubMedCrossRefGoogle Scholar
  78. 78.
    Beddall, A. C., Hill, F. G., and George, R. H., 1983, Hemophilia and tuberculosis, Lancet 1: 1226.PubMedCrossRefGoogle Scholar
  79. 79.
    Lane, H. C., and Fauci, A. S., 1985, Immunologic abnormalities in the acquired immunodeficiency syndrome, Annu. Rev. Immunol. 3:477–500.PubMedCrossRefGoogle Scholar
  80. 80.
    Anonymous, 1984, Update: Acquired immunodeficiency syndrome (AIDS)-Europe, MMWR 33:21–31.Google Scholar
  81. 81.
    Pitchenik, A. E., and Fischi, M. A., 1983, Disseminated tuberculosis and the acquired immunodeficiency syndrome, Ann. Intern. Med. 97:112.Google Scholar
  82. 82.
    Chester, A. C, and Winn, W. C, 1986, Unusual and newly recognized patterns of nontuberculous mycobacterial infection with emphasis on the immunocompromised host, Pathol. Annual 21:251–270.Google Scholar
  83. 83.
    Stover, D. E., White, D. A., Romano, P. A., and Gellene, R. A., 1984, Diagnosis of pulmonary disease in acquired immunodeficiency syndrome (AIDS). Role of bronchoscopy and bronchoalveolar lavage, Am. Rev. Respir. Dis. 130:659–662.PubMedGoogle Scholar
  84. 84.
    Berlin, O. G., Zakowski, P.. Bruchner, D. A., and Johnson, B. L. ,1984, New biphasic culture system for isolates of mycobacteria from blood of patients with acquired immune deficiency syndrome, J. Clin. Microbiol. 20:572–574.PubMedGoogle Scholar
  85. 85.
    Cohen, R. J., Samozuk, M. K., Busch, D., 1983, Occult infections with M. intracellulare in bone marrow biopsy specimens from patients with AIDS, N. Engl. J. Med. 308:1475–1476.PubMedCrossRefGoogle Scholar
  86. 86.
    Macher, A. M., Kovacs, J. A., Gill, V., et al. ,1983, Bacteremia due to M. avium-intracellulare in the acquired immunodeficiency syndrome, Ann. Intern. Med. 99:782– 785.PubMedGoogle Scholar
  87. 87.
    Pitchenik, A. E., Burr, J., and Cole, C. N., 1986, Tuberculin testing for persons with positive serologic studies for HTLV-III, N. Engl. J. Med. 314:447.PubMedGoogle Scholar
  88. 88.
    Sunderam, G., McDonald, R. J., Maniatis, T., et al. ,1986, Tuberculosis as a manifestation of the acquired immunodeficiency syndrome (AIDS),JAMA 256:357–361.CrossRefGoogle Scholar
  89. 89.
    Pitchenick, A. E., Cole, C., Russell, B. W., et al. ,1984, Tuberculosis, atypical mycobac-teriosis and the acquired immunodeficiency syndrome among Haitian and non-Haitian patients in South Florida, Ann. Intern. Med. 101:641–645.Google Scholar
  90. 90.
    Lane, H. C., and Fauci, A. S., 1985, Immunologic aspects of acquired immunodeficiency syndrome, Adv. Host Defense Mech. 5: 131–148.Google Scholar
  91. 91.
    Welch, K., Finkbeiner, W., Alpers, C. E., et al. ,1984, Autopsy findings in the acquired immune deficiency syndrome, JAMA 252: 1152–1159.PubMedCrossRefGoogle Scholar
  92. 92.
    Sohn, C. C., Schroff, R. W., Kliewer, K. E., et al. ,1982, Disseminated M. avium-intracellulare infection in homosexual men with acquired cell-mediated immunodeficiency: A histologic and immunologic study of two cases, Am. J. Clin. Pathol. 79:247– 252.Google Scholar
  93. 93.
    Dryjanski, J. ,and Gold, J. W. M., 1984, Infections in AIDS patients, Clin. Hematol. 13:709–726.Google Scholar
  94. 94.
    Blaser, M. J., and Cohn, D. L., 1986, Opportunistic infections in patients with AIDS: Clues to the epidemiology of AIDS and the relative virulence of pathogens, Rev. Infect. Dis. 8:21–30.PubMedCrossRefGoogle Scholar
  95. 95.
    Kovacs, J. A., and Mason, H., 1985, Opportunistic infections, Adv. Host Defense Mech. 5:35–58.Google Scholar
  96. 96.
    Masur, H., Michelis, M. A., Wormser, G. P., 1982, Opportunistic infection in previously healthy women. Initial manifestations of a community acquired cellular immunodeficiency, Ann. Intern. Med. 97:533–539.PubMedGoogle Scholar
  97. 97.
    Plot, P., Quinn, T. C., Taelman, H., etal. ,1984, Acquired immunodeficiency syndrome in a heterosexual population in Zaire, Lancet 2:65–69.Google Scholar
  98. 98.
    Poon, M. C., Landay, A., Prasthofer, E. F., and Stagao, S., 1983, Acquired immunodeficiency syndrome with P. carinii and M. avium-intracellulare infection in a previously healthy patient with classical hemophilia, Ann. Intern. Med. 98:287–290.PubMedGoogle Scholar
  99. 99.
    Landesman, S. H., Ginzburg, H. M., and Weiss, S. H., 1985, The AIDS epidemic. N. Engl. J. Med. 312:521–525.PubMedCrossRefGoogle Scholar
  100. 100.
    Clumeck, N., Sonnet, J., Taelman, H., et al. ,1984, Acquired immunodeficiency syndrome in African patients, N. Engl. J. Med. 310:492–497.PubMedCrossRefGoogle Scholar
  101. 101.
    Pitchenik, A. E., Fischi, M. A., Dickinson, G. M., Becker, D. M., Fournier, A. M., O’Conell, M. T., Colton, R. M., and Spira, T. J., 1983, Opportunistic infections and Kaposi’s sarcoma amongst Haitians: Evidence of a new acquired immunodeficiency state, Ann. Intern. Med. 98:277–284.PubMedGoogle Scholar
  102. 102.
    Pitchenik, A. E., Russell, B. W., Cleary, T., et al. ,1982, The prevalence of tuberculosis and drug resistance among Haitians, N. Engl. J. Med. 307:162–165.PubMedCrossRefGoogle Scholar
  103. 103.
    Pitchenik, A. E., and Rubinson, H. A., 1985, The radiographic appearance of tuberculosis in patients with acquired immune deficiency syndrome (AIDS) and pre-AIDS, Am. Rev. Respir. Dis. 131:393–396.PubMedGoogle Scholar
  104. 104.
    Roth, R. J., Owen, R. L. ,and Keren, D. F., 1983, AIDS with M. avium-intracellulare lesions resembling those of Whipple’s Disease, N. Engl. J. Med. 309: 1234–1235.CrossRefGoogle Scholar
  105. 105.
    Merkel, R. S., 1984, Paratuberculosis, Microbiol. Ser. 15:1237–1250.Google Scholar
  106. 106.
    Malebranche, R., Arnoux, E.. Guerin, J. M. ,Pierre, G. D., Laroche, A. C., 1983, Acquired immunodeficiency syndrome with severe gastrointestinal manifestations in Haiti, Lancet 2:873–877.PubMedCrossRefGoogle Scholar
  107. 107.
    Caya, J. G.. Cohen, E. B., Allendorph, M. M., Hogan, W.J., Henderson, L. A., Reedy, M. T. ,and Pelligrini, J., 1984, Atypical mycobacterial and cytomegalovirus infection of the duodenum in a patient with acquired immunodeficiency syndrome: Endoscopic and histopathologic appearance, Wisc. Med. J. 83:33–36.Google Scholar
  108. 108.
    Hopewell, P. C., and Luce, J. M. ,1985, Pulmonary involvement in the acquired immunodeficiency syndrome, Chest 87: 104–112.PubMedCrossRefGoogle Scholar
  109. 109.
    Nash, G., and Fligiel, S., 1984, Pathologic features of the lung in the acquired immune deficiency syndrome (AIDS): An autopsy study of seventeen homosexual males, Am. J. Clin. Pathol. 81:6–12.PubMedGoogle Scholar
  110. 110.
    Osborne, B. M. ,Guarda, L. A. ,and Butler, J. J., 1984, Bone marrow biopsies in patients with the acquired immunodeficiency syndrome, Hum. Pathol. 15:1048– 1053.PubMedCrossRefGoogle Scholar
  111. 111.
    Graham, B. S., Hinson, M. V., Bennett, S. R., Gregory, D. W., Schaffner, W., 1984, Acid-fast bacilli on buffy coat smears in the acquired immunodeficiency syndrome: A lesson from Hansen’s bacillus, South. Med. J. 77:246–248.PubMedCrossRefGoogle Scholar
  112. 112.
    Armstrong, D., Gold, J. W., Dryjanski, J., et al. ,1985, Treatment of infections in patients with the acquired immunodeficiency syndrome, Ann. Intern. Med. 103:733– 743.Google Scholar
  113. 113.
    Wong, B., Edwards, F. F., Kiehn, T. E., et al. ,1985, Continuous high-grade M. avium-intracellulare bacteremia in patients with the acquired immune deficiency syndrome, Am. J. Med. 78:35–40.PubMedCrossRefGoogle Scholar
  114. 114.
    Seshi, B., 1985, Two cases of AIDS with florid M. avium-intracellulare infection in the T-cell areas of the spleen, Hum. Pathol. 16:964–965.PubMedCrossRefGoogle Scholar
  115. 115.
    Cole, G. W., and Gebhard, J., 1979, M. avium infection of the skin resembling lep-romatous leprosy, Br. J. Dermatol. 101:71–74.PubMedCrossRefGoogle Scholar
  116. 116.
    Bloom, B. R., and Mehra, V., 1984, Immunological unresponsiveness in leprosy, Immunol. Rev. 80:5–28.PubMedCrossRefGoogle Scholar
  117. 117.
    Sinkovics, J. G., Gyorkey, F., Melnick, J. L., and Gyorkey, P., 1984, Acquired immune deficiency syndrome (AIDS): Speculations about its etiology and comparative immunology, Rev. Infect. Dis. 6:745–760.PubMedCrossRefGoogle Scholar
  118. 118.
    Masur, H., 1982, Mycobacterium avium-intracellulare: Another scourge for individuals with acquired immunodeficiency syndrome. JAMA 248:3013.PubMedCrossRefGoogle Scholar
  119. 119.
    Thorel, M-T., and David, H. L., 1984, Specific surface antigens of SMT variants of M. avium, Infect. Immun. 43:438–439.PubMedGoogle Scholar
  120. 120.
    Strikland, N. H., 1985, The influence of immunosuppression and immunodeficiency on infections with leprosy and tuberculosis, Int. J. Lepr. 53:886–100.Google Scholar
  121. 121.
    Lane, H. C., Masur, H., Edgar, L. C., et al. ,1983, Abnormalities of B-cell activation and immunoregulation in patients with the acquired immunodeficiency syndrome, N. Engl. J. Med. 309:453–458.PubMedCrossRefGoogle Scholar
  122. 122.
    Watson, S. R., and Collins, F. M., 1981, The specificity of suppressor T-cells induced induced by chronic M. avium infection in mice, Clin. Exp. Immunol. 43:10–19.PubMedGoogle Scholar
  123. 123.
    Mosier, D. E., Yetter, R. A., and Morse, H. C, 1985, Retroviral induction of acute lymphoproliferative disease and profound immunosuppression in adult C57BL/6 mice, J. Exp. Med. 161:766–784.PubMedCrossRefGoogle Scholar
  124. 124.
    Singer, A., and Shearer, G. M., 1986, AIDS therapy by blocking CD4+ cells, Nature (Lond.) 320:113.CrossRefGoogle Scholar
  125. 125.
    Anonymous, 1986, Diagnosis and management of mycobacterial infection and disease in persons with human T-lymphotrophic virus type III/Lymphadenopathy-associated virus infection, MMWR 35:448–452.Google Scholar
  126. 126.
    Polis, M. A., and Tuazon, C. V., 1985, Clues to early diagnosis of M. avium-intracellulare infection in patients with acquired immunodeficiency syndrome, Arch. Pathol. Lab. Med. 109:465–466.PubMedGoogle Scholar
  127. 127.
    Brandt, E. N., 1984, AIDS research: Charting new directions, Public Health Rep. 99:433–435.PubMedGoogle Scholar

Copyright information

© Plenum Press, New York 1988

Authors and Affiliations

  • Frank M. Collins
    • 1
  1. 1.Trudeau Institute, Inc.Saranac LakeUSA

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