Eosinophils and MAC and a good doctor near West Palm Beach Fl

@mcdc1959 Maybe someone here can suggest a pulmonologist near W Palm Beach? My doc is in Minnesota... Welcome to Mayo Connect. As you read here, you will find a few common threads - probably the most asked thing is "how do I find a good doctor..." Bronchiectasis and MAC are rare diseases, so people who are highly skilled in treating them are scarce and busy.
The second concern is the seemingly everlasting waiting...first we wait for an appointment, then tests, then test results, and often our treatment approach becomes "wait and watch" as well.
Fortunately, nearly all strains of MAC are slow-growing - we have often had it for years before it is diagnosed, so more waiting to begin treatment is not dangerous. Likewise, waiting to find the right doctor.

Can you answer a few questions about what led to your bronchoscopy? Are you seeing a pulmonologist, and if so, are they part of a larger group practice where perhaps someone else has more experience with MAC? Why are you not comfortable with them? And, since you are near several good-sized cities, do you have transportation to get to the right doctor if someone recommends one?
Sue

Yes, seeing a pulmonologist, have a bad cough for months. I have 2 nodules one upper right lobe and one lower middle lobe. Have had three CT scans from 9/23 to 1/12. Have been on two rounds of antibiotics Z- pack and prednisone didn’t do much for the infection. Month or so later on Leviquin 750 mg for 14 days. Was some improvement but infection still there.
Yes, it’s part of a large group practice. And yes I have transportation.

I am not a doctor but....LOL there is a lung condition with nodules that is called Churg Strauss (sp?) and it is an autoimmune disease that has eosinophils involved. You might also want to see a Rheumatologist for an opinion. The reason I know about this is that I have a similar auto immune disease but not the same and I have bronchiectasis plus nodules but no eosinophils. The subject was discussed by my allergist and rheumatologist way back. Just a thought.

Thank you very much. I had also recently heard of that condition and will discuss it with my pulmonary physician. I will be going for allergy testing maybe that will help …

Hi Mcdc,

I've been hearing more and more about high eosinophils and bronchiectasis. In some situations, it can be a co-morbidity such as having asthma or COPD in addition to BE and in others it might be eosinophilic bronchiectasis. There was discussion about this subset of people with BE at a recent NYU Langone professional conference.

I am not a clinician but it seems to me it would be prudent to get a bronchiectasis expert in your area. One source is the NTM Info and Research physician referral list: https://ntminfo.org/united-states-of-america/

However, I would suggest joining a support group in your area and learning from them and who they see. To find the best group contact the NTM info & Research Engagement Officer, Patriacia Kemp at info@ntm.org.

I know that Dr Margaret Johnson is a BE/NTM expert at the Mayo in Jacksonville. It can take months to get in to see her, which is the case with most of the BE/NTM specialists.
It might seem counterintuitive, but sometimes, a colleague is better because they can give you more time.

Lastly, if your doctor suspects MAC, azithromycin is generally not used as a monotherapy to treat infections. This is because if you have a MAC infection, azithromycin is one of the best drugs to kill MAC bacteria and you want to prevent your bacteria from developing resistance to it. As a person with a history of a MAC infection, my doctor who is a BE/NTM specialist prescribes Levoquin for me to have "just in case" while traveling.

All the best and let me know if you have any questions,
Linda Esposito

Thank you for all that great information. My doctor put me on Levaquin but did nothing! I was hesitant to go on Levaquin before all my test came in just for that resistance reason. Again, thanks for all the info!

Hi,
My eosinophils went high twice when I had lung infections twice. After the infections were treated, it came down.

Ling

Did you know what caused your infections and was Prednisone given to treat it?

I had these two, (PSEUDOMONAS AERUGINOSA 2+
Nonmucoid
STAPHYLOCOCCUS AUREUS 2+ and treated. Just did sputum test and I am fine. I remember I took one antibiotic for 10 days. My ID doctor said once you have pseudomonas, it is very hard to get rid of. He did the
sputum, it came back ok.
My pulmonologist. said I might have adult onset asthma because eosinophils level is high. I don't have to do anything to keep it down, which makes me think it connected to my infections.
Hope this helps.
Ling

Good to know thanks for the info!