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Mycobacterium avium-intracellulare brain abscesses in an HIV-infected patient

Christopher Begley1, Akshay Amaraneni1, Larry Lutwick1

  • 1Department of Internal Medicine, Homer Stryker M.D. School of Medicine, Western Michigan University, Kalamazoo, MI, USA.

Idcases
|January 22, 2016
PubMed

Insights

Mycobacterium avium-intracellulare complex (MAC) brain abscesses are rare in acquired immunodeficiency syndrome (AIDS) patients. This case highlights successful MAC treatment after initial therapies failed, leading to abscess resolution.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Immunology

Background:

  • Mycobacterium avium-intracellulare complex (MAC) is an opportunistic pathogen.
  • Brain abscesses are uncommon manifestations of MAC, particularly in individuals with acquired immunodeficiency syndrome (AIDS).
  • Neurological complications in AIDS patients can be diverse and challenging to diagnose.

Purpose of the Study:

  • To report a rare case of multiple MAC brain abscesses in an AIDS patient.
  • To illustrate the diagnostic challenges and treatment course for MAC brain abscesses.
  • To emphasize the importance of considering MAC in refractory CNS infections in immunocompromised individuals.

Main Methods:

  • Case presentation of an AIDS patient with neurological symptoms.
  • Diagnostic confirmation through brain biopsy and microbiological culture for MAC.
  • Review of initial empirical treatments for toxoplasmosis and bacterial abscesses.

Main Results:

  • The patient presented with weakness, confusion, and headaches.
  • Initial treatments for toxoplasmosis and pyogenic bacterial abscesses were ineffective.
  • Diagnosis of multiple MAC brain abscesses was confirmed via biopsy and culture.
  • Successful resolution of brain abscesses was achieved following targeted MAC therapy.

Conclusions:

  • MAC should be considered in the differential diagnosis of brain abscesses in AIDS patients, especially when initial treatments fail.
  • Prompt and accurate diagnosis through biopsy and culture is crucial for effective management.
  • Antimycobacterial therapy can effectively treat MAC brain abscesses, leading to favorable outcomes in immunocompromised patients.
Keywords:
Brain abscessHIV/AIDSMycobacterium avium–intracellulare

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