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Psoas Abscess Due to Mycobacterium avium in A Patient with Chronic Lymphocytic Leukemia－Case Report and Review

Natascha D Diaco1,2, Bettina Strohdach3, Anna L Falkowski4

  • 1University Department of Medicine, Kantonsspital Baselland, University of Basel, 4101 Bruderholz, Switzerland. natascha.diaco@stud.unibas.ch.

Journal of Clinical Medicine
|February 10, 2019
PubMed

Insights

Chronic lymphocytic leukemia (CLL) patients on new treatments face opportunistic infections like Mycobacterium avium. Early diagnosis and prophylaxis are crucial for managing these serious complications.

Area of Science:

  • Oncology
  • Infectious Diseases
  • Hematology

Background:

  • Infections are a significant risk for chronic lymphocytic leukemia (CLL) patients.
  • Newer CLL treatments like obinutuzumab offer improved survival but may still carry infection risks.
  • Opportunistic infections, including non-tuberculous mycobacteria (NTM), have been reported in CLL patients.

Purpose of the Study:

  • To highlight a case of Mycobacterium avium infection in a CLL patient treated with obinutuzumab.
  • To review the literature on opportunistic infections in CLL.
  • To emphasize the importance of considering and diagnosing opportunistic infections in CLL.

Main Methods:

  • Case presentation of a 74-year-old male with CLL and a psoas muscle abscess.
  • Diagnostic confirmation using broad-spectrum mycobacterial PCR, M. avium-specific PCR, and mycobacterial culture on inguinal node biopsy.
  • Literature review on opportunistic infections in CLL patients.

Main Results:

  • The patient was diagnosed with Mycobacterium avium infection.
  • The case underscores the potential for opportunistic infections in CLL patients, even with newer therapies.
  • Differential diagnosis from CLL progression, Richter's transformation, or secondary malignancy is critical.

Conclusions:

  • Physicians must maintain a high index of suspicion for opportunistic infections in CLL patients.
  • Accurate diagnosis requires histological and microbiological evaluation of affected tissues.
  • Prophylactic measures, including vaccinations and immune globulin replacement, should be considered for CLL patients.
Keywords:
Mycobacterium aviumabscesschronic lymphocytic leukemiaibrutinibimmunosuppressioninfectionnon-tuberculous mycobacteriaobinutuzumab

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