Treatment typically lasts at least 12 months.Although studies have not yet identified an optimal regimen or confirmed that any therapeutic regimen produces sustained clinical benefit for patients with disseminated MAC, the Task Force concluded that the available information indicated the need for treatment of disseminated MAC. The Public Health Service, therefore, recommends that regimens be based on the following principles:
Treatment regimens outside a clinical trial should include at least two agents. Every regimen should contain either azithromycin or clarithromycin; many experts prefer ethambutol as a second drug. Many clinicians have added one or more of the following as second, third, or fourth agents: clofazimine, rifabutin, rifampin, ciprofloxacin, and in some situations amikacin. Isoniazid and pyrazinamide are not effective for the therapy of MAC. Therapy should continue for the lifetime of the patient if the clinical and microbiologic improvement is observed.Clinical manifestations of disseminated MAC—such as fever, weight loss, and night sweats—should be monitored several times during the initial weeks of therapy. The microbiologic response, as assessed by blood culture every 4 weeks during initial therapy, can also be helpful in interpreting the efficacy of a therapeutic regimen. Most patients who ultimately respond show substantial clinical improvement in the first 4–6 weeks of therapy. Elimination of the organism from blood cultures may take somewhat longer, often requiring 4–12 weeks. HIV-infected children
HIV-infected children less than 12 years of age also develop disseminated MAC. Some age adjustment is necessary when clinicians interpret CD4+ T-lymphocyte counts in children less than 2 years of age.
Odontogenic cyst are a group of jaw cysts that are formed from tissues involved in odontogenesis (tooth development). Odontogenic cysts are closed sacs, and have a distinct membrane derived from rests of odontogenic epithelium. It may contain air, fluids, or semi-solid material. Intra-bony cysts are most common in the jaws, because the mandible and maxilla are the only bones with epithelial components. That odontogenic epithelium is critical in normal tooth development. However, epithelial rests may be the origin for the cyst lining later. Not all oral cysts are odontogenic cyst. For example, mucous cyst of the oral mucosa and nasolabial duct cyst are not of odontogenic origin. In addition, there are several conditions with so-called (radiographic) pseudocystic appearance in jaws; ranging from anatomic variants such as Stafne static bone cyst, to the aggressive aneurysmal bone cyst. Classification
I. Cysts of the jaws
A. Epithelial-lined cysts
1. Developmental origin
(a) Odontogenic
i. Gingival cyst of infants
ii. Odontogenic keratocyst
iii. Dentigerous cyst
iv. Eruption cyst
v. Gingival cyst of adults
vi. Developmental lateral periodontal cyst
vii. Botryoid odontogenic cyst
viii. Glandular odontogenic cyst
ix. Calcifying odontogenic cyst
(b) Non-odontogenic
i. Midpalatal raphé cyst of infants
ii. Nasopalatine duct cyst
iii. Nasolabial cyst
2. Inflammatory origin
i. Radicular cyst, apical and lateral
ii. Residual cyst
iii. Paradental cyst and juvenile paradental cyst
iv. Inflammatory collateral cyst
B. Non-epithelial-lined cysts
1. Solitary bone cyst
2. Aneurysmal bone cyst
II. Cysts associated with the maxillary antrum
1. Mucocele
2. Retention cyst
3. Pseudocyst
4. Postoperative maxillary cyst
III. Cysts of the soft tissues of the mouth, face and neck
1. Dermoid and epidermoid cysts
2. Lymphoepithelial (branchial) cyst
3. Thyroglossal duct cyst
4. Anterior median lingual cyst (intralingual cyst of foregut origin)
5.