Localized Pulmonary Infection Associated with Mycobacterium tilburgii in an HIV–Infected Patient

Abstract

The case of an HIV-infected patient with low CD4+ cell count and localized pulmonary infection associated with Mycobacterium tilburgii, a recently recognized atypical mycobacterial species, is reported. Diagnosis was confirmed by repeated detection of mycobacterial DNA in lung biopsy specimens. After surgical removal of the pulmonary nodules, treatment with antimycobacterial combination therapy led to a complete and sustained recovery of the respiratory symptoms.M. tilburgii so far has only been described to cause disseminated infection in three patients, two of them suffering from acquired immunodeficiency syndrome. To our knowledge, this is the first report of localized pulmonary disease attributed to this mycobacterial species. As it responds to antimycobacterial combination therapy, efforts to establish the diagnosis using PCR methods in patients with suspected pulmonary disease due to mycobacteria other than tuberculosis should be undertaken.

Molecular Characterization of a Novel Fastidious Mycobacterium Causing Lepromatous Lesions of the Skin, Subcutis, Cornea, and Conjunctiva of Cats Living in Victoria, Australia

“…The nucleotide sequences of the 182-bp fragment flanked by the primers SP1 and SP2 were identical for all of the products, and a BLASTN search of the GenBank nr databases revealed the highest nucleotide identity (95%) with the ITS1 region of "Mycobacterium tilburgii" (accession no. AJ580827) (16) and 93 to 94% similarity to other members of the M. simiae-related group. A 225-bp PCR product likewise was amplified from DNA extracts from two dogs diagnosed with CLGS.…”

“Mycobacterium tilburgii” Infection in Two Immunocompromised Children: Importance of Molecular Tools in Culture-Negative Mycobacterial Disease Diagnosis

“…tilburgii was first identified in a sample from an immunocompetent adult patient in the city of Tilburg, The Netherlands (2); the species presented in the form of a disseminated infection and was later described as a causative pathogen in infections of three patients with HIV-AIDS and 1 patient with prolonged prednisolone treatment (5,6) In both of our pediatric cases, M. tilburgii was associated with defects in the IFN-␥-IL-12 pathway. Defects in that pathway are known to increase susceptibility to mycobacterial disease (7,13).…”

“…Clinical experiences described in the literature show the use of various therapy durations and antibiotics combinations, some of which were initially intended for treatment of infections by M. tuberculosis complex or Mycobacterium avium and all of which included clarithromycin. In 3 out of 5 cases, a quinolone was included in the treatment regimen (2,5,6). In case A, the patient responded well to standard antituberculous medication and no relapse occurred when a combination of clarithromycin and ciprofloxacin was administered.…”

"Mycobacterium tilburgii" Infections

“…Both previously reported M. tilburgii patients had AIDS, 1 of whom had a disease similar to that of the second patient in this report ( 9 ). Taken together, 3 patients had gastrointestinal involvement with yellow mucosal plaques (Figure A1), and 1 patient had pulmonary nodules ( 10 ). One of the 4 patients did not have a detectable immunodeficiency, yet had gastrointestinal and urinary bladder lesions.…”