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Proctitis Caused by Mycobacterium avium-intracellulare in an HIV-Infected Patient

Jose Armando Gonzales Zamora1, Clara Milikowski2

  • 1Division of Infectious Diseases, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, USA. jxg1416@med.miami.edu.

Diseases (Basel, Switzerland)
|May 9, 2018
PubMed

Insights

Mycobacterium avium-intracellulare can cause infectious proctitis in individuals with HIV. Acid-fast bacilli stool cultures are recommended when sexually transmitted disease testing is negative.

Area of Science:

  • Infectious Diseases
  • Gastroenterology
  • Microbiology

Background:

  • Infectious proctitis is commonly linked to sexually transmitted diseases, particularly in HIV-infected patients.
  • The role of Mycobacterium avium-intracellulare (MAI) in infectious proctitis is not well-documented.

Observation:

  • A case report of an HIV-infected patient with a CD4 count of 304 cells/uL and undetectable HIV viral load.
  • The patient presented with symptoms of constipation and painful defecation.
  • Endoscopic examination revealed shallow rectal ulcerations, and histopathology showed poorly formed granulomas.

Findings:

  • Stool culture isolated Mycobacterium sp., identified as Mycobacterium avium-intracellulare via DNA probe.
  • The patient achieved successful treatment with a three-drug regimen including azithromycin, ethambutol, and rifabutin.

Implications:

  • This case highlights MAI as a potential, albeit uncommon, cause of infectious proctitis in immunocompromised individuals.
  • Acid-fast bacilli (AFB) stool culture should be considered in proctitis cases where initial investigations for sexually transmitted diseases are inconclusive.
Keywords:
HIVMycobacterium avium-intracellulareproctitis

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