A case report of mycobacterium avium complex peritonitis in an AIDS patient

Area of Science:

• Infectious Diseases
• Immunology
• Gastroenterology

Background:

• Mycobacterium avium complex (MAC) infections are opportunistic pathogens, posing a significant risk to individuals with advanced Human Immunodeficiency Virus (HIV) infection and severely compromised immune systems (low CD4 counts).
• While disseminated MAC commonly affects organs like the spleen, lymph nodes, liver, and intestines, peritoneal involvement is exceptionally rare.
• Peritonitis, inflammation of the peritoneum, can arise from various causes, but MAC-induced peritonitis is an uncommon presentation.

Purpose of the Study:

• To report a rare case of Mycobacterium avium complex (MAC) peritonitis in a patient with acquired immunodeficiency syndrome (AIDS).
• To highlight the importance of considering MAC peritonitis in the differential diagnosis of abdominal symptoms in immunocompromised patients.
• To emphasize the clinical presentation and successful treatment of this rare condition.

Main Methods:

• A case study of a 26-year-old female patient diagnosed with AIDS and presenting with symptoms suggestive of peritonitis.
• Review of the patient's clinical presentation, including abdominal pain, distension, anorexia, diarrhea, and cough.
• Documentation of the treatment regimen and patient's response.

Main Results:

• The patient, diagnosed with AIDS and noncompliant with highly active antiretroviral therapy (HAART), presented with nonspecific abdominal symptoms.
• Diagnosis of MAC peritonitis was considered, and the patient was treated with a combination of rifabutin, clarithromycin, and ethambutol.
• Adjunctive therapy with atovaquone was administered for Pneumocystis jiroveci pneumonia prophylaxis, leading to significant clinical improvement.

Conclusions:

• Mycobacterium avium complex (MAC) peritonitis is an infrequent but serious complication in patients with advanced AIDS and low CD4 counts.
• Nonspecific abdominal symptoms in the context of AIDS and severe immunosuppression warrant consideration of MAC peritonitis.
• Prompt diagnosis and appropriate multi-drug antimicrobial therapy, alongside antiretroviral therapy and prophylaxis, can lead to favorable outcomes in MAC peritonitis.