Fever is the main symptom of MAC, along with night sweats, chills, weight loss, muscle wasting, abdominal pain, fatigue (often caused by anemia), and diarrhea. MAC can also cause enlargement of the liver and spleen, as well as the lymph nodes.
Occasionally, people with a latent MAC infection who start antiretroviral therapy for the first time when their CD4 counts are below 200—and who have a rapid CD4 increase—may have a "flare" of MAC symptoms. This does not mean that the disease is active, but that the immune system is now reacting to the latent infection. This is called immune reconstition inflammatory syndrome (IRIS). The most obvious symptoms are swollen lymph nodes and fever. If needed, corticosteroids can be used to treat the symptoms of IRIS.
To diagnose MAC, blood and/or bone marrow samples are collected and sent to a lab for testing. To collect a sample of bone marrow, a doctor inserts a needle into the hip bone, usually near the top of the butt or the lower back. Collecting blood samples to look for MAC is no different from blood samples collected to check viral load or CD4 cell counts.
In order to check for MAC, the organisms must be "grown out" in test tubes. This can take approximately seven days, thus treatment—if MAC is suspected—is often started before a diagnosis is confirmed.
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