Mycobacterium haemophilum infection in a patient with acquired immune deficiency syndrome

Abstract

Mycobacterium haemophilum was isolated from wrist and ankle aspirates as the organism responsible for tenosynovitis in a patient with acquired immune deficiency syndrome. Mycobacterium isolates recovered from synovial fluid were identified as hemin requiring by their failure to grow on subculture unless the medium was supplemented with hemin. M. haemophilum is of low virulence and rarely associated with infections in humans. This is the first documented case of M. haemophilum infection in a patient with acquired immune deficiency syndrome.

Agents of newly recognized or infrequently encountered mycobacterial diseases.

“…Approximately 90% of the mycobacterioses in AIDS patients involve either M. avium or M. tuberculosis (63,139). Many other species of PPEM, e.g., M. asiaticum (63), M. flavescens (63), members of the M. fortuitum complex (60, 63), M. gordonae (25,60,63,144,242), M. haemophilum (115,156), M. kansasii (63,78,144,242), M. malmoense (63), M. marinum (103), M. scrofulaceum (63, 80), M. simiae (108,139), M. smegmatis (242), and M. xenopi (4,43,51,139), have been implicated in the remaining 10% of the cases of mycobacterial disease in AIDS patients (63).…”

“…The two nontransplant cases were from Australia and involved a 58-year-old male with lymphocytic lymphoma (128) and a 1-year-old, otherwise healthy child who developed submandibular lymphadenitis (48). In 1985, M. haemophilum was isolated in Europe from a 48-year-old male renal transplant patient with cytomegalovirus infection (16), and in 1987 and 1988 it was isolated from three AIDS patients (115,156), one in New York and two in Maryland, respectively. A special awareness of M. haemophilum in Australia, stimulated by the early case reports and studies on growth requirements undertaken in the State Department of Health Laboratory in Queensland (47,48,128), may be the reason this organism was recognized more frequently in that region.…”

Intracellular growth and cytotoxicity of Mycobacterium haemophilum in a human epithelial cell line (Hec-1-B)

“…Mycobacterium haemophilum is rapidly emerging as a serious pathogen, particularly of immunocompromised human populations (reviewed in reference 15). Infections with M. haemophilum occur most often in patients with Hodgkin's disease (18), renal transplants (9), and with increasing frequency, AIDS (5,19,28). Infections in immunocompetent children have also been reported (2).…”

First case of Mycobacterium haemophilum infection in an AIDS patient in Italy**

“…Atypical mycobacterial infections are major complications in subjects with AIDS, and recently the pathogenetic significance of M. haemophilum has been recognized in these individuals. 9 M. haemophilum , an organism of low virulence, is emerging as a pathogen in persons who are severely immunocompromised by AIDS infection as well as after renal, bone marrow, and cardiac transplantation, lymphoma, rheumatoid arthritis, and in children with apparently normal immune function. M. haemophilum infection should be considered in immunologically compromised hosts who develop multiple erythematous papules or nodules (with a light central area that becomes necrotic) on the extremities and less commonly on the trunk and face, osteomyelitis, and pneumonia of uncertain cause.…”