Focal Mycobacterium avium Complex Osteomyelitis in Patients with HIV Infection

Hospenthal, Duane R.; Miller, RF; Thomas, Stephen J.; Oster, Charles N.

doi:10.1097/00019048-200101000-00005

Cited by 3 publications

(3 citation statements)

References 27 publications

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“…However, most cases lacked constitutional symptoms, and out of 10 case reports that included the result of mycobacterial blood cultures near the time of MAC osteomyelitis diagnosis, only 1 was positive. Therefore, as others have suggested, MAC osteomyelitis may be the result of transient, often asymptomatic, mycobacteremia that inoculates bone [ 7 – 10 ]. Alternatively, osteomyelitis may occur secondary to contiguous spread from infected pulmonary, gastrointestinal, or regional lymph nodes that erode into adjacent bony structures.…”

Section: Discussionmentioning

confidence: 99%

“…Several patients had been prescribed MAC prophylaxis before presentation, demonstrating that MAC prophylaxis is not perfectly effective or, as others have suggested, may have limited infection before immune reconstitution [ 7 , 10 , 13 – 15 ]. Alternatively, MAC infection may have been acquired before initiation of prophylaxis or adherence to prophylaxis may have been imperfect.…”

Section: Discussionmentioning

confidence: 99%

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Mycobacterium avium Complex Osteomyelitis in Persons With Human Immunodeficiency Virus: Case Series and Literature Review

Wood

Buitrago

Patel³

et al. 2015

Open Forum Infectious Diseases

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In persons with advanced immunosuppression, Mycobacterium avium complex (MAC) typically causes disseminated disease with systemic symptoms. We report 2 cases in which MAC caused localized osteomyelitis in human immunodeficiency virus (HIV)-infected individuals on antiretroviral therapy with rising CD4 counts. We summarize 17 additional cases of HIV-associated MAC osteomyelitis from the literature and compare CD4 count at presentation for vertebral cases versus nonvertebral cases, which reveals a significantly higher CD4 at presentation for vertebral cases (median 251 cells/µL vs 50 cells/µL; P = .043; Mann–Whitney U test). The literature review demonstrates that the majority of cases of MAC osteomyelitis, especially vertebral, occurs in individuals with CD4 counts that have increased to above 100 cells/µL on antiretroviral therapy. Among HIV-infected individuals with osteomyelitis, MAC should be considered a possible etiology, particularly in the setting of immune reconstitution.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Mycobacterium avium Complex Osteomyelitis in Persons With Human Immunodeficiency Virus: Case Series and Literature Review

Wood

Buitrago

Patel³

et al. 2015

Open Forum Infectious Diseases

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“…1 It is unusual to find this bacterium in the bone or joint because main clinical manifestation usually are pulmonary. 1 It is unusual to find this bacterium in the bone or joint because main clinical manifestation usually are pulmonary.…”

Section: Discussionmentioning

confidence: 99%

Mycobacterium avium intracellulare septic arthritis in a patient with dermatomyositis

Wool

Shenberger

2014

Current Orthopaedic Practice

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A Case of Mycobacterium avium Complex Vertebral Osteomyelitis in a Patient With Human Immunodeficiency Virus

Amin¹,

Rosshandler²,

Norris³

et al. 2023

Infect Dis Clin Pract

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Mycobacterium avium complex (MAC) infection is one of the most common bacterial opportunistic infections in persons living with human immunodeficiency virus (PLWH). Mycobacterium avium complex infections are caused by either M. avium or Mycobacterium intracellulare, which are nontuberculous mycobacterial species. Mycobacterium avium complex is prevalent in soil, water, and animals in the environment. Mycobacterium avium complex infections are commonly seen in persons with CD4 counts less than 50 cells/μL and are the most common cause of disseminated disease in immunocompromised patients. Vertebral osteomyelitis caused by MAC, however, remains uncommon in PLWH, with few cases reported in the literature (Lancet Infect Dis. 2004;4:557–565; Infect Dis Clin Pract. 2001;10:17–20). We present a case of vertebral osteomyelitis secondary to MAC in a person with human immunodeficiency virus and compare 10 other cases reported in the literature. Our case also highlights the importance of resuming secondary MAC prophylaxis when CD4 counts decline below 100 cells/μL in PLWH.

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Focal Mycobacterium avium Complex Osteomyelitis in Patients with HIV Infection

Cited by 3 publications

References 27 publications

Mycobacterium avium Complex Osteomyelitis in Persons With Human Immunodeficiency Virus: Case Series and Literature Review

Mycobacterium avium Complex Osteomyelitis in Persons With Human Immunodeficiency Virus: Case Series and Literature Review

Mycobacterium avium intracellulare septic arthritis in a patient with dermatomyositis

A Case of Mycobacterium avium Complex Vertebral Osteomyelitis in a Patient With Human Immunodeficiency Virus

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