Infection with a Fastidious Mycobacterium Resembling <i>Mycobacterium simiae</i> in Seven Patients with AIDS

Wald, Anna; Coyle, Marie B.; Carlson, L. C.; Thompson, Robert L.; Hooton, Thomas M.

doi:10.7326/0003-4819-117-7-586

Cited by 42 publications

(26 citation statements)

References 3 publications

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“…Although most cases of M. genavenseinfection in patients with AIDS identified to date have occurred in central Europe, the geographic range of the organism is unknown. Our cases together with those recently reported from Seattle [3] bring the total number of documented M. genavense infections in the United States to nine. Nothing is known about the ecology of this mycobacterium, although a recent report indicated that infection due to M. genavense occurs in pet birds [17].…”

Section: Microbiologymentioning

confidence: 99%

“…Khalil et al [13] included M. tuberculosis and MAC in the differential diagnosis of splenic abscesses in HI V-positive patients. In the recent series of cases reported by Wald et al [3], four of seven patients with M. genavense infection had splenic involvement; two patients had splenomegaly, one patient's spleen ruptured during splenectomy, and examination ofautopsy-obtained specimens of the third patient's spleen revealed AFB. Four of 18 patients with disseminated M. genavense infection whose cases were reported by Bottger et al [2] had splenomegaly, as did two of three children whose cases were recently reported by Nadal et al [14].…”

Section: Microbiologymentioning

confidence: 99%

“…This growth may require months of incubation. Recently, Bottger et al genavense infection has ranged from 2 months to > 14 months [1,3]. One ofour patients had little or no response to therapy and died after 5 months (death was caused by another opportunistic infection).…”

Section: Microbiologymentioning

confidence: 99%

“…To date only two small series of cases in which M. genavense infection occurred outside of Europe have been published: one series was from the United States [3], the other was from Australia [4]. We report the cases of two patients with M. genavenseinfection who were seen at The University oflowa Hospitals and Clinics.…”

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confidence: 99%

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Disseminated Mycobacterium genavense Infection in Two Patients with AIDS

Gaynor

Clark²,

Koontz

et al. 1994

Clinical Infectious Diseases

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Mycobacterium genavense is a recently defined fastidious organism that has been identified as a cause of disseminated infection in patients with AIDS. We report the cases of two patients who had advanced AIDS and a clinical syndrome of fever, anorexia, abdominal pain, diarrhea, and weight loss. In addition, splenomegaly and lymphadenopathy were prominent in both cases, and in one patient's case radiographic findings were suggestive of splenic abscesses. Mycobacteria isolated from specimens of blood and bone marrow grew in liquid media but not on solid media.The results of DNA probe tests for Mycobacterium tuberculosis and Mycobacterium avium complex were false-positive for both patients. After treatment of the broth cultures to lyse red blood cells, the results of DNA probe tests were negative for these pathogens. Amplification and sequencing of 16S rRNA with use of the polymerase chain reaction indicated that the mycobacterial isolates from both patients had sequences identical to those previously reported for M.genavense. One patient survived 5 months after diagnosis, the other 2 months after diagnosis; only one patient responded (transiently) to antimycobacterial chemotherapy.Improvements in antimicrobial therapy have led to increased life-spans among patients infected with the human immunodeficiency virus (HIV). These severely immunocompromised individuals are at increased risk for mycobacterial infections through either reactivation or new acquisition of the microorganisms. Disseminated mycobacterial disease in the late stages of AIDS is most commonly the result of infection with Mycobacterium avium complex (MAC). Despite multidrug therapy, most patients' clinical conditions improve only minimally.In 1990 Hirschel et al. [1] reported the case of a patient with advanced AIDS who developed a syndrome characterized by fever, anorexia, diarrhea, and weight loss. Staining of biopsies of duodenum and bone marrow and blood buffy coat samples revealed acid-fast bacilli (AFB), which grew in liquid BACTEC medium but not on a variety of solid media. Case ReportsCase 1. A 35-year-old homosexual man was found to be seropositive for HIV in 1988. His CD4 lymphocyte count was 150/J,LL and he received therapy with zidovudine. Apart from a mild bout of Pneumocvstis carinii pneumonia and recurrent perirectal ulcers (caused by herpes simplex), his condition was stable until March 1992, when he developed constant abdominal pain, diarrhea, and weight loss. At that point his CD41ymphocyte count was 82/J,LL. Examination of stool specimens revealed only Giardia cysts, but he failed to respond to two courses of therapy with metronidazole. An abdominal ultrasonogram showed splenomegaly. The patient became anemic, and biopsy of bone marrow revealed AFB and multiple granulomata. The patient was treated with rifampin, ethambutol, clofazimine, ciprofloxacin, and isoniazid, but his symptoms persisted. Endoscopy revealed candidal esophagitis, and biopsy of the duodenum revealed AFB. A computerized tomography (CT) scan showed hepatospleno...

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Section: Microbiologymentioning

confidence: 99%

Section: Microbiologymentioning

confidence: 99%

Section: Microbiologymentioning

confidence: 99%

mentioning

confidence: 99%

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Disseminated Mycobacterium genavense Infection in Two Patients with AIDS

Gaynor

Clark²,

Koontz

et al. 1994

Clinical Infectious Diseases

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“…Recently, we described a putative new species, tentatively named "Mycobacterium genavense," which frequently causes disseminated infections in patients with AIDS (2,3,6,12,16). Histopathologically, infection with "M. genavense" in human immunodeficiency virus-positive patients is characterized by masses of foamy histiocytes and, depending on the immunological reactivity of the host, by ill-formed granulomata (11).…”

mentioning

confidence: 99%

Mycobacterium genavense sp. nov.

Böttger

Hirschel

Coyle

1993

International Journal of Systematic Bacteriology

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Strains of a suggested novel type of mycobacterium have been repeatedly isolated from patients with AIDS. We summarize the results of tests performed to determine enzymatic activities and metabolic properties, the results of fatty acid analyses, and the results of a comparative 16s rRNA sequence determination. We propose formally that this organism represents a new species, Mycobacterium genavense. The type strain is strain 2289, a culture of which has been deposited in the American Type Culture Collection as strain ATCC 51234.

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