Do you sometimes feel tired for no reason, or have a cough that lasts for a long time? Although we don't pay much attention to such small things in our daily lives, there may be reasons behind them that we should be a little concerned about. Well, today we are going to talk about a disease caused by a special group of bacteria that can affect our lungs. This is called MAC Lung Disease .
What is MAC lung disease?
Simply put, MAC lung disease is an infection of our lungs caused by a group of bacteria called Mycobacterium avium complex (MAC) . This bacteria is actually always around us, in dust, soil, and water. Even though these bacteria enter the body when we breathe or swallow something, most people do not get sick. However, for some people, especially those who already have certain weaknesses in their lungs or those who have a low immune system, when this MAC bacteria enters the respiratory tract, a serious infection can develop. This infection causes difficulty breathing. If diagnosed late, it can also be a little difficult to treat. The most important thing is that this MAC lung disease is not a disease that can be transmitted from person to person.
What does MAC bacteria look like?
MAC bacteria are members of a large family of bacteria called Nontuberculous mycobacteria (NTM) . There are about 200 types of NTM. MAC bacteria are responsible for about 80% of NTM infections in the lungs in countries like the United States.
Think about it, this NTM infection is not like the Tuberculosis (TB) we all know. Tuberculosis is a disease that spreads from person to person and can quickly become serious. The bacteria that causes it are also different, called `(Mycobacterium tuberculosis)`.
There are many different species of mycobacteria within the MAC group, but the treatment and management of the disease are largely the same.
How common is MAC lung disease?
There are more than 86,000 people with NTM infections in the United States alone. MAC lung disease is the most common, accounting for about 80% of NTM infections. The number of NTM lung patients has been increasing steadily over the past two decades , and experts say this trend will continue.
What types of MAC infections are there?
MAC infections can be divided into several main types:
- Pulmonary MAC infections: These are those that directly affect our lungs and respiratory system.
- Disseminated MAC infections: These are infections that spread throughout the body through the bloodstream. They are most often seen in people whose immune systems are severely weakened by conditions such as AIDS .
- MAC-associated lymphadenitis: This mainly affects healthy children. Lymph nodes, or lymph nodes, become swollen in places like the neck.
There are two main types of MAC lung disease...
There are two main forms of MAC lung disease that we see:
1. Nodular bronchiectasis: This is when the infection develops in the small airways and air sacs in the lungs, and they look like small nodules on the lungs on examination. These nodules can grow very large. This long-term infection causes a condition called bronchiectasis . This means that the airways become irreversibly dilated, like an old rubber tube that is stretched. This makes it difficult to treat infections and increases the risk of new infections. This type is most often seen in older, thin, non-smoking women. If left untreated, conditions such as bronchitis and pneumonia can develop.
2. Fibrocavitary disease: This is the most severe form of MAC lung disease. It needs to be treated quickly. If the infection causes holes (cavities) in the lung tissue, the infection is very deep and can be challenging to treat. This condition is most common in smokers or people with conditions like emphysema.
How does MAC lung disease develop?
We have already talked about how MAC bacteria are naturally found in soil and water. When we dig up soil and stir up dust, this bacteria can be released into the air and enter our bodies when we breathe. People who work in plantations and are often in contact with soil may be exposed to MAC bacteria more than others. Also, this bacteria is present in water, and it can be present in the water we use at home. Chlorination, disinfectants, and sometimes even heating the water do not kill this bacteria. This may sound a little scary, but most people are not harmed by this bacteria. We are all exposed to NTM bacteria almost every day, but most people do not develop an infection.
However, in a small number of people with certain risk factors, the bacteria can travel to the lungs and grow very slowly, sometimes for years. This MAC lung infection causes low-level inflammation and irreversible changes in the airways, until the disease is diagnosed and treated.
Who is at higher risk of developing MAC lung disease?
MAC lung disease can develop at any age and in any gender, but people over the age of 65 and women who have gone through menopause are at higher risk.
Additionally, you are more likely to develop MAC lung disease if:
- If you are a smoker.
- If your immune system is weak.
- If you have a lung condition like this:
- (Bronchiectasis) (and conditions leading to bronchiectasis)
- (Chronic obstructive pulmonary disease - COPD )
- (Cystic fibrosis)
- (Emphysema)
- If you have previously had tuberculosis (TB).
What are the symptoms of MAC lung disease?
The symptoms of MAC lung disease are varied, and because they are nonspecific, diagnosis can be delayed. Some people may have very mild or even unnoticeable symptoms. Sometimes symptoms may not be related to the respiratory system. If symptoms do occur, you may experience:
- Chronic cough (with or without phlegm). Imagine someone like Nilanthi, who has had a cough for months, and the phlegm is coming out little by little, but she thinks it's just a common cold.
- Coughing up blood (Hemoptysis) .
- Fatigue .
- Low-grade fever (usually between 37.5 and 37.9 degrees Celsius - 99.6 F to 100.3 F).
- Sweating at night.
- Shortness of breath .
- Unexplained weight loss and loss of appetite.
- Chest pain.
- Anxiety.
How is MAC lung disease diagnosed?
Your doctor will first examine you and ask about your symptoms.
Tests used to diagnose MAC lung disease include:
- Chest X-rays and especially CT scans. These can detect changes in the lungs caused by infection.
- Sputum cultures. This involves taking a sample of phlegm from your lungs and testing it to see if it grows the MAC bacteria. Since we are all exposed to MAC bacteria every day, this test may be done several times over a few days to make sure that the bacteria is actually coming from your lungs.
- Bronchoscopy. This is like a colonoscopy, but it is done on the lungs (using a different, smaller instrument). It is done when a diagnosis cannot be made with sputum tests.
What are the treatments for MAC lung disease?
Because MAC lung disease is a bit more difficult to treat, you will need to see an infectious disease specialist or a pulmonary specialist. Both of these doctors have specialized knowledge in diagnosing and treating infections.
Treatment for MAC lung disease varies depending on the severity of symptoms. They may include:
- Watchful waiting: People with minimal symptoms and no significant changes in their lungs on tests may not need treatment with antibiotics initially. However, they will need to see their doctor regularly and have breathing and sputum tests.
- Airway clearance: This is a group of treatments that help the lungs clear mucus (and the bacteria in it) from the diseased airways. It is often used for bronchiectasis. It includes various breathing treatments given through a nebulizer , as well as the use of certain devices that help clear mucus from the lower parts of the lungs.
- Medications: If clearing your airways isn’t enough, your doctor may prescribe antibiotics . The decision to start treatment will depend on a number of factors and a discussion with your specialist. Sometimes bacteria can become resistant to antibiotics , meaning they can’t be killed by the drugs. To reduce this risk and completely kill the bacteria, you may need to take three different types of antibiotics over a period of 12 to 18 months. For people who don’t respond to other antibiotics within six months, the US Food and Drug Administration (FDA) recently approved an inhaled antibiotic.
- Surgery: Very rarely, if antibiotics do not help, surgery may be needed to remove the infected part of the lung. After surgery, you will need to take antibiotics for a short period of time to kill any remaining bacteria.
How do we live with MAC lung disease? (Management)
These things can help relieve the symptoms of MAC lung disease:
- Find ways to clear mucus from your airways. These include getting at least 150 minutes of moderate-intensity exercise per week (especially if you qualify for pulmonary rehab ), learning about chest and breathing techniques from a respiratory therapist, controlled coughing, postural drainage (postures that help clear mucus from the lungs), and chest percussion to loosen mucus.
- Get help to quit smoking , and avoid second-hand smoke and other things that are harmful to your lungs.
- Get vaccinated. Protect yourself from additional respiratory illnesses like flu, pneumonia, and COVID-19.
- Maintain a healthy weight through a nutritious diet. Many centers have dietitians who can help with nutritional deficiencies caused by slow-healing infections like MAC.
What are the possible complications of MAC lung disease?
Using antibiotics for a long time can increase the risk of antibiotic resistance . It can also cause side effects of the drugs, such as nausea, diarrhea, and stomach pain. Each antibiotic has its own specific side effects, so it's important to talk to your doctor about them.
Older people are at risk of developing a bacterial infection called Clostridium difficile (C. diff) when they take antibiotics for a long time. This happens because antibiotics kill the good bacteria in the gut that help with digestion. C. diff infection affects the digestive system and causes severe, chronic diarrhea. This can be life-threatening.
Severe MAC lung disease may prevent you from doing the things you used to enjoy. As a result, you may experience depression or anxiety.
How can I reduce the risk of developing MAC lung disease?
These steps can reduce your risk of exposure to MAC bacteria:
- If your doctor thinks that the source of your MAC bacteria may be hot tubs or saunas, avoid hot, steamy, and repetitive water circulation areas.
- Turn on the ventilation systems in the bathroom and kitchen to remove the steam.
- Set your home's hot water heater to at least 54.4 degrees Celsius (130 Fahrenheit).
- Wear a dust mask when working in the garden or gardening.
- Before working with potting soil, sprinkle some water on it to reduce dust.
- Adhere to an aggressive airway clearance regimen.
Can MAC lung disease be completely cured?
If sputum tests show no infection for 12 months, doctors consider MAC lung disease cured. However, the infection can recur. This can be due to new exposure to the bacteria or to bacteria that have remained in the lungs, especially if you still have the condition that caused MAC in the first place (such as lung weakness).
Your doctor will monitor you for recurrence of the infection. The damage to your lungs from MAC lung disease cannot be reversed. You may still have trouble breathing after treatment. Therefore, it is important to have clear goals and expectations before starting treatment.
Things to ask your doctor...
You may want to ask your doctor about things like:
- How did I get MAC lung disease?
- What type of MAC lung disease do I have?
- Do I need treatment?
- What treatment options do I have?
- Is surgery right for me? What are the risks of surgery?
- Are there things I can do at home to make my breathing easier?
- How can I avoid MAC lung infections in the future?
Is this contagious from person to person?
Although you can't catch MAC from someone else, sometimes the condition affects several members of the same family. Experts believe that some people have a genetic mutation that makes them more susceptible to MAC infections.
Can MAC lung disease be fatal?
In some people, MAC lung disease can lead to respiratory failure and even death. But this usually happens over a long period of time. About 1 in 4 people with a weakened immune system and cavitary type MAC lung disease die within five years of diagnosis.
Early diagnosis and treatment can greatly reduce long-term risks.
Most people do not get sick from MAC bacteria. For those who do, MAC lung disease can cause serious, sometimes life-threatening breathing problems. If you cough up blood, or if you have a persistent cough and feel very tired, you should definitely see a doctor. People with weakened immune systems and those with other lung diseases are especially susceptible to MAC lung disease. MAC lung disease can be treated with antibiotics, but you may need to take the medication for more than a year.
Finally, things to remember...
MAC lung disease is a condition that we should be a little concerned about. However, there is nothing to worry about. The most important thing is to see a doctor as soon as possible if you have symptoms, get an accurate diagnosis, and get the right treatment. If so, we can live a normal life with this disease. If you have any more questions about this, don't hesitate to ask your doctor. Stay healthy!
` MAC lung disease, Mycobacterium avium complex, NTM infection, lung infections, chronic cough, respiratory diseases, bacterial infections
💬 අදහස් (0)
තවමත් කිසිදු අදහසක් පළ කර නොමැත. ඔබේ අදහස පළමු වරට මෙහි එක් කරන්න.
ඔබේ අදහස එක් කරන්න