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Bubo masquerading as an incarcerated inguinal hernia.
K R Hodge1, R J Orgler, T Monson
1Department of Surgery, University of Connecticut, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102, USA.
Hernia : the Journal of Hernias and Abdominal Wall Surgery
|August 17, 2001
Summary
A patient presented with an inguinal mass that was diagnosed as Mycobacterium avium-intracellulare (MAI) infection. Despite CD4 lymphopenia, HIV testing remained negative, suggesting MAI can cause lymphopenia without HIV.
Area of Science:
- Infectious Diseases
- Immunology
- Surgical Pathology
Background:
- A 44-year-old male motorcyclist presented with a painful, irreducible inguinal mass.
- Previous lung biopsy in 1998 showed miliary granuloma.
Observation:
- Exploration revealed no hernia; incision of the mass identified acid-fast bacilli.
- Subsequent culture confirmed Mycobacterium avium-intracellulare (MAI) as the causative agent.
Findings:
- Blood tests revealed CD4 lymphopenia.
- Human Immunodeficiency Virus (HIV) testing was negative at presentation and remained so two years later.
Implications:
- This case highlights MAI as a potential cause of inguinal masses and CD4 lymphopenia in immunocompetent individuals.
- It underscores the importance of considering atypical mycobacterial infections in the differential diagnosis of unexplained lymphopenia and localized masses.