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Mycobacterium avium complex peritonitis in an AIDS patient
1Division of Infectious Diseases, Beth Israel Deacones Medical Center, Boston, Massachusetts 02215, USA.
Abstract:
Mycobacterium avium complex (MAC) frequently disseminates in AIDS patients, where the gastrointestinal tract is a major target organ. While ascites in AIDS patients is common, peritonitis secondary to MAC is rare. We describe the first case of MAC peritonitis in an AIDS patient without underlying cirrhosis, portal hypertension, chylous ascites or peritoneal dialysis. This case highlights the need to be aware of atypical presentations of MAC disease in AIDS patients with a history of disseminated MAC, even those who compliantly take highly active antiretroviral therapy.
Insights
Peritonitis secondary to Mycobacterium avium complex (MAC) is rare in patients with acquired immunodeficiency syndrome (AIDS). This case highlights atypical MAC presentations in AIDS patients, even those on therapy.
Area of Science:
- Infectious Diseases
- Immunology
Background:
- Mycobacterium avium complex (MAC) commonly disseminates in individuals with acquired immunodeficiency syndrome (AIDS).
- The gastrointestinal tract is a frequent target organ for disseminated MAC in AIDS patients.
- While ascites is common in AIDS, MAC-induced peritonitis is an infrequent complication.
Observation:
- This report details the first documented case of MAC peritonitis in an AIDS patient.
- The patient had no pre-existing conditions such as cirrhosis, portal hypertension, chylous ascites, or peritoneal dialysis.
- The patient was compliant with highly active antiretroviral therapy (HAART).
Findings:
- Atypical presentation of MAC peritonitis in an immunocompromised patient.
- MAC peritonitis can occur in AIDS patients despite HAART and absence of typical risk factors.
Implications:
- Clinicians should consider MAC peritonitis in AIDS patients with disseminated MAC history, even if on HAART.
- Awareness of unusual MAC manifestations is crucial for timely diagnosis and management in AIDS.
- This case expands the spectrum of opportunistic infections in advanced HIV disease.