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Disseminated Mycobacterium lentiflavum infection in a human immunodeficiency virus-infected patient.

ABSTRACT: We report the first case of Mycobacterium lentiflavum disseminated infection in a human immunodeficiency virus-infected patient. Conventional identification procedures failed to identify the mycobacterial strain, but sequencing of the 16S rRNA gene led to the species identification. Furthermore, we describe here the analysis of the 16S-23S rRNA internal transcribed spacer sequence of M. lentiflavum.

SUBMITTER: Niobe SN

PROVIDER: S-EPMC88078 | biostudies-literature | 2001 May

REPOSITORIES: biostudies-literature

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Disseminated Mycobacterium lentiflavum infection in a human immunodeficiency virus-infected patient.

Niobe S N SN Bebear C M CM Clerc M M Pellegrin J L JL Bebear C C Maugein J J

Journal of clinical microbiology 20010501 5

We report the first case of Mycobacterium lentiflavum disseminated infection in a human immunodeficiency virus-infected patient. Conventional identification procedures failed to identify the mycobacterial strain, but sequencing of the 16S rRNA gene led to the species identification. Furthermore, we describe here the analysis of the 16S-23S rRNA internal transcribed spacer sequence of M. lentiflavum. ...[more]

PMID: 11326043

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Project description:BackgroundSarcoidosis is a systemic inflammatory disease that is characterized by non-caseating epithelioid-cell granulomas upon histology. However, similar histological findings may also be seen with certain infections. Thus, differentiation from infection is pivotal to ensure appropriate treatment. Here, we present a case of a disseminated infection with Mycobacterium genavense owing to an interleukin 12 receptor subunit beta 1 (IL-12Rβ1) associated immunodeficiency in a previously healthy female who was initially misdiagnosed with sarcoidosis. M. genavense is a nontuberculous mycobacterium which can cause lymphadenopathy, gastrointestinal and bone marrow infiltration in immunocompromised patients. With this case report we aim to highlight that an infection with M. genavense on the ground of a genetic defect of mycobacterial immune control may represent a rare differential diagnosis of sarcoidosis.Case presentationA 31-year-old female was referred to our hospital with progressive lymphadenopathy, hepatosplenomegaly, pancytopenia and systemic inflammation. She had previously been evaluated for generalized lymphadenopathy in another hospital. At that time, lymph node biopsies had revealed sarcoid-like lesions and a systemic corticosteroid treatment was initiated based on a putative diagnosis of sarcoidosis. When her condition worsened, she was transferred to our university clinic, where the diagnosis of disseminated M. genavense infection owing to an inborn interferonopathy was made. Her family history revealed that her brother had also suffered from IL-12Rβ1 deficiency and had died from a systemic infection with M. genavense at the age of 21. The patient received antimycobacterial treatment combined with subcutaneous type I interferon, which eventually led to a gradual improvement over the next months.ConclusionsDifferentiating between sarcoidosis and sarcoid-like lesions secondary to infections may be challenging, especially when pathogens are difficult to detect or not expected in an apparently immunocompetent patient. Patients with IL-12Rβ1-associated immunodeficiency may be asymptomatic until adulthood, and disseminated M. genavense infection on the grounds of an IL-12Rβ1-associated immunodeficiency may represent a rare differential diagnosis of sarcoidosis.

Dataset Information

Disseminated Mycobacterium lentiflavum infection in a human immunodeficiency virus-infected patient.

Publications

Disseminated Mycobacterium lentiflavum infection in a human immunodeficiency virus-infected patient.

Similar Datasets

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