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Isolated intracranial infection with Mycobacterium avium complex
R D Dickerman1, Q E Stevens, R Rak
1Department of Neurosurgery, Long Island Jewish Hospital, New Hyde Park, NY 11004, USA. drrdd@yahoo.com
Journal of Neurosurgical Sciences
|November 18, 2003
Summary
This case report details an isolated central nervous system (CNS) infection caused by Mycobacterium avium-intracellulare complex (MAC). Treatment involved antimycobacterial medications and neurosurgery for refractory intracranial infection.
Area of Science:
- Infectious Diseases
- Neurology
- Immunology
Background:
- Mycobacterium avium-intracellulare complex (MAC) commonly causes respiratory and systemic infections, particularly in immunocompromised individuals.
- Central nervous system (CNS) involvement by MAC is rare, with limited case reports available.
- This study focuses on a unique presentation of isolated intracranial MAC infection.
Observation:
- A single case of a patient with an isolated intracranial infection due to MAC is presented.
- The patient exhibited low production of interferon-gamma (INF-gamma) and tumor necrosis factor-alpha (TNF-alpha).
- Despite thorough investigations, no other site of MAC infection was identified in the patient.
Findings:
- Initial treatment with antimycobacterial medications proved refractory.
- The patient underwent suboccipital craniotomy and evacuation of a cerebellar mass.
- Immunohistochemical investigations confirmed the diagnosis of MAC infection within the CNS.
Implications:
- Intracranial infectious lesions caused by MAC warrant consideration of conventional systemic antibiotic regimens as first-line therapy.
- Neurosurgical intervention should be considered for medically refractory cases of intracranial MAC infections.
- This case highlights the importance of considering rare CNS infections and tailored treatment approaches.