When patients fail therapy, we have few options for treatment. However, even today, treatment success rates average only 66% among patients with macrolide-susceptible disease who take the American Thoracic Society recommended regimen ( 9) for at least a year ( 10). It was not until the availability of macrolides that we began to see improvement in treatment outcomes ( 10). Today, these organisms, as well as at least 10 other species ( 8), are collectively referred to as Mycobacterium avium complex or MAC.Įarly experience with treating MAC pulmonary disease was fraught with failure ( 9). Eventually, these causative organisms were identified as Mycobacterium avium ( 6), followed by identification of Mycobacterium intracellulare in 1949 ( 7). However, it was not until the 1930s that the causative strains were identified as human pathogens ( 1– 3), and by 1942, only 25 cases of human avian tuberculosis had been reported ( 4, 5). Probable human cases of “avian tuberculosis” were reported as early as the late 1880s. The cause of this disease was an “avian” mycobacteria. Once upon a time, 1868 to be exact, someone noticed that chickens developed “tuberculosis” ( 1). When I used to read fairy tales, I fancied that kind of thing never happened, and now here I am in the middle of one!įairy tales do come true.
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