MAC infection in knee?

Posted by lisw @lisw, Jun 22, 2023

I have MAC in my lungs and recently began treatment. Failed total knee replacement January 26, 2023 and scheduled revision surgery for October 2023. Knee becoming more swollen and painful. Orthopedist now suspects MAC in my knee. Anyone else with this?

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Amen to everything you said Sue.

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@equanimous

From what I was told, I got the impression that having MAC in the lungs is a bit better than having it anywhere else in the body where it may spread faster. So, I guess, in some weird way, we should count our lucky stars (?!). My mantra that helps me get through the rough days: "Things could always be worse."

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And… This too shall pass.

Gets me through many bad days

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This does make me think. I was working in the flower bed and on my knees and within a few days a little spot came up on one knee that kept getting more sore. I thought it could be a sticker but couldn’t get anything out of it but clear liquid. A swollen hump came up on the inside of my knee close to where the sticker seemed to be. My whole knee has swollen up but mostly where the knot is. I had wondered if the bacteria could have traveled from my lung to my knee. My knee is a little sore but hasn’t slowed me down any. I am now going to address this with the pulmonary doctor I see for the first time tomorrow.
Thank you for posting about your knee. That post might help me figure out what is wrong with mine.

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@sueinmn

Well, the bad news is NTM (non-tubercular mycobacteria) is everywhere - in the air, water and soil. Further bad news - there are hundreds of known strains.
The good news is, most strains don't cause infection in humans. And more good news is, even those which do generally only infect a miniscule percent of the population. For something that is everywhere - only one person in 1000 (.1%) develops an NTM infection needing treatment in any year.
Usually, NTM infects people with already unhealthy lungs - those who have Bronchiectasis or Cystic Fibrosis, or people with severely compromised immune systems. And it is treatable. NTM infections like the one mentioned from the guy with the imbedded cactus spine are so rare as to practically be medical oddities.

I'm afraid if I worried about being exposed to NTM, I would need to live in a sterile bubble. Instead, I just use airway clearance and a healthy lifestyle with reasonable precautions to keep MAC and Pseudomonas from settling into my lungs again. It has been working for 3 1/2 years now with no drugs!
Sue

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Well, I finally saw a pulmonologist yesterday for my MAC and he said I need to take the 3 antibiotics or do the nebulizer. Because of side effects I chose to stay on only azithromycin and B Complex and B12 shots plus all my other immune boosting things. He was nice. Told me azithromycin would not kill the bug (as he called it) and I could possibly turn it into a superbug that could not be stopped but if I am feeling good with just what I am doing he agreed to that and said we would do a CT in 4 months and see if it has progressed then make choices. I feel like the body is capable of many things so onward I will go with a positive attitude that I can suppress this with what I am doing. I am to active to let these drugs get me down. Life is to short as it is. Oh, he also told me that it is not what is wrong with my knee. He actually said it doesn’t go to the knees. Anyway, all is good 😊

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@rchildress

Well, I finally saw a pulmonologist yesterday for my MAC and he said I need to take the 3 antibiotics or do the nebulizer. Because of side effects I chose to stay on only azithromycin and B Complex and B12 shots plus all my other immune boosting things. He was nice. Told me azithromycin would not kill the bug (as he called it) and I could possibly turn it into a superbug that could not be stopped but if I am feeling good with just what I am doing he agreed to that and said we would do a CT in 4 months and see if it has progressed then make choices. I feel like the body is capable of many things so onward I will go with a positive attitude that I can suppress this with what I am doing. I am to active to let these drugs get me down. Life is to short as it is. Oh, he also told me that it is not what is wrong with my knee. He actually said it doesn’t go to the knees. Anyway, all is good 😊

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Boy, I would really heed his warning about the Azithromycin but that is just me!

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@rchildress

Well, I finally saw a pulmonologist yesterday for my MAC and he said I need to take the 3 antibiotics or do the nebulizer. Because of side effects I chose to stay on only azithromycin and B Complex and B12 shots plus all my other immune boosting things. He was nice. Told me azithromycin would not kill the bug (as he called it) and I could possibly turn it into a superbug that could not be stopped but if I am feeling good with just what I am doing he agreed to that and said we would do a CT in 4 months and see if it has progressed then make choices. I feel like the body is capable of many things so onward I will go with a positive attitude that I can suppress this with what I am doing. I am to active to let these drugs get me down. Life is to short as it is. Oh, he also told me that it is not what is wrong with my knee. He actually said it doesn’t go to the knees. Anyway, all is good 😊

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Are you using 7% saline nebs and airway clearance to help knock out the MAC? If so, I might be comfortable with this approach, otherwise yeah - my PCP believes overuse of Z-Paks (azithromycin) has contributed to the increase in superbugs. Azithromycin is a "big gun" in the antibiotic arsenal, and we need to ne very careful it doesn't become useless as a weapon.
Sue

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@irenea8

Boy, I would really heed his warning about the Azithromycin but that is just me!

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I agree with Irene!

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@sueinmn

Are you using 7% saline nebs and airway clearance to help knock out the MAC? If so, I might be comfortable with this approach, otherwise yeah - my PCP believes overuse of Z-Paks (azithromycin) has contributed to the increase in superbugs. Azithromycin is a "big gun" in the antibiotic arsenal, and we need to ne very careful it doesn't become useless as a weapon.
Sue

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I am not using a nebulizer at all. My airways are not a problem and I breathe fine. Wouldn’t know I was even sick if not for the test results. Once I started the azithromycin I started feeling so much better.
I have a nurse practitioner looking into ways to really boost my immune system to fight this then I will quit taking the azithromycin and see how I feel. It apparently has been doing some good because I did start feeling good pretty quickly after starting it. I am just not willing to sacrifice possibly loosing my eyesight and I already have non-alcohol fatty liver and watched my dad recently die with cardiac cirrhosis of the liver and sure don’t want that either. Guess I am trying yo find lessor of all evils.

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@rchildress

I am not using a nebulizer at all. My airways are not a problem and I breathe fine. Wouldn’t know I was even sick if not for the test results. Once I started the azithromycin I started feeling so much better.
I have a nurse practitioner looking into ways to really boost my immune system to fight this then I will quit taking the azithromycin and see how I feel. It apparently has been doing some good because I did start feeling good pretty quickly after starting it. I am just not willing to sacrifice possibly loosing my eyesight and I already have non-alcohol fatty liver and watched my dad recently die with cardiac cirrhosis of the liver and sure don’t want that either. Guess I am trying yo find lessor of all evils.

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If you have MAC in your lungs, something is not normal in your airways. 90% of the time I breathe fine too, but...MAC only can take hold and grow if there are pockets of mucus for it to hide in - if your airways expel all the mucus in the normal course of the day, there is no home for it. If the CT shows MAC - either nodules or cavities, you need help to expel it. And it takes many months, if not years, to grow enough so you test positive for it in a culture.

Here is what Dr McShane, one of the foremost experts in treating NTM (non-tubercular mycobacteria) of which MAC is one type, has to say on the topic:


You might want to discuss this, sooner rather than later, with your doc.
Sue

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@rchildress

I am not using a nebulizer at all. My airways are not a problem and I breathe fine. Wouldn’t know I was even sick if not for the test results. Once I started the azithromycin I started feeling so much better.
I have a nurse practitioner looking into ways to really boost my immune system to fight this then I will quit taking the azithromycin and see how I feel. It apparently has been doing some good because I did start feeling good pretty quickly after starting it. I am just not willing to sacrifice possibly loosing my eyesight and I already have non-alcohol fatty liver and watched my dad recently die with cardiac cirrhosis of the liver and sure don’t want that either. Guess I am trying yo find lessor of all evils.

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But you could nebulize 7% saline and that is the best way to keep the MAC at bay and help your body fight it. Then you might not need the Azithromycin?

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