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In patients with increased CD4 counts on ART who develop atypical manifestations of MAC, it may be prudent to treat for a prolonged period of 12-18 months and then continue chronic suppressive therapy for life.

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Thus, long-term clarithromycin prophylaxis administered to 100 patients would be expected to prevent 27 cases of disseminated MAC over the median lifetime of the population at risk (36 expected disseminated MAC cases minus 9 observed cases per 100 patients, assuming a median survival of 19 months).

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This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Edzard Ernst has identified about 700 cases of serious complications among the medical literature.

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Isolates of MAC have only a single copy of the ribosome, and hence, macrolide monotherapy carries a significant risk of the development of mutational resistance.

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Its clear that certain counties are in many ways less behind than the rest of the nation.

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This physician, whose gender I withhold in the interest of anonymity and because the disease is genderneutral, is burned out in what should be the honeymoon of a career.

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