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Case 3: Prophylaxis for Mycobacterium avium complex

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D The patient's symptoms of weight loss and night sweats suggest he may possibly have disseminated MAC. Before prophylaxis against disseminated MAC is started, disseminated MAC infection should be ruled out.

This answer is correct. The patient's constitutional symptoms and anemia suggest that he may have disseminated MAC. Accordingly, studies should be performed to rule out disseminated MAC before initiating prophylaxis, since single drug prophylaxis used in a patient with disseminated MAC could result in development of drug-resistant MAC. If blood cultures for MAC remain negative after several weeks, then prophylaxis against disseminated MAC prophylaxis should be started.

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