Mycobacterium ulcerans infection as a cause of chronic diarrhea in an AIDS patient: A case report

Huh, Jin-Gook; Kim, You‐Sun; Lee, Jong-Sung; Jeong, Tae-Yeob; Ryu, S.M.; Lee, Jung Hwan; Moon, Jeong Seok; Kang, Yong-Seok; Shim, Myung-shup; Oh, Myoung‐don

doi:10.3748/wjg.14.808

Cited by 6 publications

(5 citation statements)

References 23 publications

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“…species, especially from the M. avium complex (MAC), were also detected in the feces of HIV-infected patients at frequencies of around 15% but without significant association with diarrhea 46,56,62,68 . However, case reports show the unequivocal involvement of non-tuberculous mycobacteria, such as M. ulcerans, in chronic diarrhea 47 and M. avium intracellular-caused duodenitis in these patients 79 .…”

Section: Bacteriamentioning

confidence: 96%

Etiological agents of diarrhea in patients infected by the human immunodeficiency virus-1: a review

Rossit¹,

Gonçalves

Franco

et al. 2009

Rev. Inst. Med. trop. S. Paulo

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Despite the importance of understanding the epidemiology of agents responsible for infectious diarrhea in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) population, the number of articles about this subject is relatively few. The current article summarizes published data on bacterial, fungal, viral and parasitic enteropathogens in the HIV/AIDS seropositive subjects in different countries, regions and localities. In general, there is a great difference in the frequencies of etiological agents due to factors which include immune status, geographical location, climate and socioeconomic conditions. It is important to stress that a great prevalence of infection by emergent agents has been reported in the more advanced stages of AIDS. Therefore, to establish specific treatment depends directly on knowledge of these agents and risk factors associated to their distribution. Moreover, the colonization by potential pathogenic agents verified in these individuals is high thus implicating that they act as carriers. Finally, public health measures of control and prevention must take into consideration the regional previously identified enteropathogens, especially in areas where HIV prevalence is high.

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Section: Bacteriamentioning

confidence: 96%

Etiological agents of diarrhea in patients infected by the human immunodeficiency virus-1: a review

Rossit¹,

Gonçalves

Franco

et al. 2009

Rev. Inst. Med. trop. S. Paulo

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“…Mycobacterium avium is known to be the most frequently isolated NTM from the gastrointestinal tract among immunocompromised patients [25]. However, this was not the case in this study because Mycobacterium gordonae was the most frequently isolated species in our patients, followed by M. Kansasii and M. genavense.…”

Section: Discussionmentioning

confidence: 58%

“…Findings on endoscopy include multiple raised nodules or normal-appearing mucosa. Other findings may include ulceration, erythema, oedema, friability, reduced mucosal vascularity, stricture, and aphthous erosions [11, 12]. The prevalence of NTM in intestinal specimens such as stool, intestinal lavage and colon biopsies is unknown.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic yield of nontuberculous mycobacteria in patients booked for endoscopy at the University Teaching Hospital, Lusaka

2017

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BackgroundThe intestinal carriage of nontuberculous mycobacteria (NTM) is associated with disease, especially in severely immunocompromised individuals. These organisms, although often considered contaminants, have been known to cause various types of illnesses. We aimed to determine the prevalence of and associated factors for NTM among patients booked for colonoscopy at the University Teaching Hospital (UTH) in Lusaka.MethodsWe randomly recruited 97 patients attending routine endoscopy procedures between November 2012 and October 2013 and after consent, administered a structured questionnaire. We collected stool and intestinal lavage samples, as well as biopsy samples from the descending colon and the caecal area during the endoscopy procedure. Samples were cultured using the mycobacteria growth indicator tube (MGIT) method followed by the GenoType Mycobacterium CM/AS assay for identification of NTM. Results were expressed as means and standard deviations; proportions were expressed as percentages with corresponding 95% confidence intervals. We used Fisher’s exact Chi square test for cross-tabulations where appropriate. All statistical tests were two-sided, with a significance level set at p < 0.05.ResultsOut of the 97 patients, 45 (46.4%) were female and 52 (53.6%) were males with mean ages 49.1 (±16.7, range 24–85) and 44.4 (±15.0, range 18–80) years respectively. The prevalence of NTM was 7.2% (95% CI 1.9–12.4), while that of Mycobacterium tuberculosis (MTB) was 6.2% (95% CI 2.3–13.0). Carriage of NTM was not significantly associated with age, sex or presenting symptoms such as diarrhoea, abdominal pain, weight loss as well as HIV status. There were no identifiable predictors of NTM carriage.ConclusionThe results have shown that NTM and MTB are present in the intestines of the patients booked for colonoscopy at the University Teaching Hospital in Lusaka, but their presence is not related to presenting symptoms. Given that this may be an indicator of a bigger burden of NTM in this population, there is a need to explore this burden and the contribution it could have on abdominal disease in general as well as examine potential factors that might be important predictors.

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“…Cough, sputum, hemosputum, and weight loss are common symptoms of NTM infection ( 5 , 12 , 13 ), although abdominal symptoms, such as diarrhea, are uncommon. In addition, intestinal NTM infection is generally quite rare, although Huh et al reported that M. avium-intracellulare complex (MAC) was one of the common causes of intestinal infection in patients with acquired immunodeficiency syndrome, and that intestinal MAC infection may lead to diarrhea ( 14 , 15 ). The side effects of macrolide, a key drug for the treatment of NTM infection, also include abdominal symptoms, such as diarrhea.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary <i>Mycobacterium abscessus</i> Infection with Reactive AA Amyloidosis: A Case Report and Brief Review of the Literature

et al. 2019

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We herein report a case involving a 64-year-old Japanese woman with a pulmonary Mycobacterium abscessus infection complicated by reactive AA amyloidosis, which, to our knowledge, has not been reported to date. The patient underwent gastrointestinal endoscopy for diarrhea during the treatment of pulmonary M. abscessus infection and was diagnosed with AA amyloidosis according to the histopathological findings from the endoscopic specimen. She died four months later. The prognosis of AA amyloidosis associated with pulmonary M. abscessus infection may be very poor, and physicians should pay attention to this rare condition when difficult-to-treat diarrhea occurs in patients with pulmonary M. abscessus infection.

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Mycobacterium ulcerans infection as a cause of chronic diarrhea in an AIDS patient: A case report

Cited by 6 publications

References 23 publications

Etiological agents of diarrhea in patients infected by the human immunodeficiency virus-1: a review

Etiological agents of diarrhea in patients infected by the human immunodeficiency virus-1: a review

Diagnostic yield of nontuberculous mycobacteria in patients booked for endoscopy at the University Teaching Hospital, Lusaka

Pulmonary <i>Mycobacterium abscessus</i> Infection with Reactive AA Amyloidosis: A Case Report and Brief Review of the Literature

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