Mycobacterium avium-intracellulare brain abscess in HIV-positive patient

Area of Science:

• Infectious Diseases
• Neurology
• Immunology

Background:

• Mycobacterial opportunistic infections pose a significant threat to patients living with HIV (PLHIV), contributing to high morbidity and mortality globally.
• Nontuberculous mycobacterial (NTM) infections are prevalent in individuals with advanced acquired immunodeficiency syndrome (AIDS), specifically those with CD4 counts below 50 cells/mm³.
• Mycobacterium avium complex (MAC) is a common bacterial opportunistic infection in severely immunocompromised patients, alongside other conditions like cryptococcal meningitis and progressive multifocal leukoencephalopathy.

Observation:

• Common clinical manifestations of Mycobacterium avium complex include fever, lymphadenitis, and respiratory symptoms.
• Immune reconstitution inflammatory syndrome (IRIS) can present with MAC infections in PLHIV undergoing highly active antiretroviral therapy.
• Central nervous system (CNS) involvement due to NTM infections is infrequently documented.

Findings:

• This report details a rare case of central nervous system involvement in a patient with advanced acquired immunodeficiency.
• The patient presented with a brain abscess caused by Mycobacterium avium intracellulare, a specific type of NTM.

Implications:

• This case underscores the importance of considering rare NTM manifestations, including CNS involvement, in immunocompromised patients.
• Accurate diagnosis and management of NTM brain abscesses are crucial for improving outcomes in PLHIV.
• Further research into the pathogenesis and clinical spectrum of NTM CNS infections in PLHIV is warranted.