Central nervous system infection due to <i>Mycobacterium haemophilum</i> in a patient with acquired immunodeficiency syndrome

Buppajarntham, Aubonphan; Apisarnthanarak, Anucha; Rutjanawech, Sasinuj; Khawcharoenporn, Thana

doi:10.1177/0956462414535750

Cited by 9 publications

(5 citation statements)

References 11 publications

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“…A common theme is negative results even in a case where solid media cultures were supplemented with hemin. Negative diagnostic testing led to empiric antibiotic treatment most times 4,7–9 …”

Section: Discussionmentioning

confidence: 99%

“…Negative diagnostic testing led to empiric antibiotic treatment most times. 4,[7][8][9] Specific culture techniques, Mycobacterium species immunostaining, and molecular testing should be considered along with empiric initiation of therapy for suspected M. haemophilum. Similar granulomatous inflammation can be seen in other mycobacterial diseases or inflammatory disorders such as neurosarcoidosis, making directed testing imperative.…”

Section: The Challenge Of Ntm Confirmationmentioning

confidence: 99%

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Mycobacteriumhaemophilum Related Myelitis in Geographically Linked Cases

Samudralwar,

Bailey,

Vellimana

et al. 2023

Annals of Neurology

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Section: Discussionmentioning

confidence: 99%

Section: The Challenge Of Ntm Confirmationmentioning

confidence: 99%

Mycobacteriumhaemophilum Related Myelitis in Geographically Linked Cases

Samudralwar,

Bailey,

Vellimana

et al. 2023

Annals of Neurology

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“…All had advanced HIV disease: 2 patients had multiple brain abscesses, which was similar to those previously described, and 1 patient had myelitis. A total of 2 of 3 previous case reports of CNS involvement in patients with M. haemophilum infection were from Thailand and in HIV-infected patients ( 11 , 12 ), whereas the 2 largest case series (23 and 15 cases) reported from the United States found no cases of CNS involvement ( 3 , 4 ). Further study is needed to determine whether genetic or environmental factors will influence clinical manifestations of M. haemophilum infection.…”

Section: Discussionmentioning

confidence: 99%

“…Two previous case reports of persons with CNS disease were successfully treated with surgical excision in combination with antimicrobial drugs, although there were residual neurologic deficits ( 11 , 13 ). Another study reported a case-patient who did not respond to medical therapy alone and subsequently died ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Treatment Outcomes for Patients Infected withMycobacterium haemophilum

Nookeu¹,

Angkasekwinai²,

Foongladda³

et al. 2019

Emerg. Infect. Dis.

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Mycobacterium haemophilum is a nontuberculous mycobacterium that can infect immunocompromised patients. Because of special conditions required for its culture, this bacterium is rarely reported and there are scarce data for long-term outcomes. We conducted a retrospective study at Siriraj Hospital, Bangkok, Thailand, during January 2012–September 2017. We studied 21 patients for which HIV infection was the most common concurrent condition. The most common organ involvement was skin and soft tissue (60%). Combination therapy with macrolides and fluoroquinolones resulted in a 60% cure rate for cutaneous infection; adding rifampin as a third drug for more severe cases resulted in modest (66%) cure rate. Efficacy of medical therapy in cutaneous, musculoskeletal, and ocular diseases was 80%, 50%, and 50%, respectively. All patients with central nervous system involvement showed treatment failures. Infections with M. haemophilum in HIV-infected patients were more likely to have central nervous system involvement and tended to have disseminated infections and less favorable outcomes.

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“…This bacterium can infect immunocompromised patients and transplant recipients but may also affect immunocompetent individuals as a cause for cervical lymphadenitis (scrofula) [4][5][6]. M. haemophilum infection within the central nervous system (CNS) is rare and, to our knowledge, only six reports in the English literature have described the neuropathologic findings of the infection, all of which are based on surgical biopsy material [7][8][9][10][11][12][13]. This underreporting may relate to the inherent challenges of culturing this organism using conventional microbiological methods [3].…”

Section: Introductionmentioning

confidence: 99%

Meningomyeloencephalitis secondary to Mycobacterium haemophilum infection in AIDS

Leskinen

Flowers

Thoene

et al. 2020

acta neuropathol commun

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Infections by opportunistic non-tuberculous mycobacteria (NTM) are rising in global incidence. One emerging, slowly growing NTM is Mycobacterium haemophilum, which can cause skin, lung, bone, and soft tissue infections in immunocompromised patients as well as lymphadenitis in immunocompetent individuals. Detection of this microorganism is difficult using conventional culture-based methods and few reports have documented involvement of this pathogen within the central nervous system (CNS). We describe the neuropathologic autopsy findings of a 39-year-old man with AIDS who died secondary to M. haemophilum CNS infection. He initially presented with repeated bouts of pyrexia, nausea and vomiting, and altered mental status that required numerous hospitalizations. CSF infectious workups were consistently negative. His most recent admission identified hyperintensities within the brainstem by MRI and despite antibiotic therapies for suspected CNS infection, he died. Autopsy revealed a swollen brain with marked widening of the brainstem. Microscopic examination of the brain and spinal cord showed focal lymphohistiocytic infiltrates, gliosis and neuronal loss that were associated with acid-fast bacilli (AFB). The brainstem was the most severely damaged and AFB were found to congregate along arterial territories lending support to the notion of hematogenous spread as a mechanism for the organisms' dissemination. 16S rRNA sequencing on formalin-fixed paraffin-embedded tissue enabled post-mortem identification of M. haemophilum. This sequencing methodology may permit diagnosis on CSF intra-vitam.

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Central nervous system infection due to Mycobacterium haemophilum in a patient with acquired immunodeficiency syndrome

Cited by 9 publications

References 11 publications

Mycobacteriumhaemophilum Related Myelitis in Geographically Linked Cases

Mycobacteriumhaemophilum Related Myelitis in Geographically Linked Cases

Clinical Characteristics and Treatment Outcomes for Patients Infected withMycobacterium haemophilum

Meningomyeloencephalitis secondary to Mycobacterium haemophilum infection in AIDS

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