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Isolated mediastinal lymphadenitis caused by Mycobacterium malmoense in an immunocompromised child
Hiroshi Sakihama1, Tadashi Matsubayashi2, Kiyofumi Ohkusu3
1Department of Pediatrics, Seirei Hamamatsu General Hospital; Department of Pediatric Critical Care Medicine, Hyogo Prefectural Kobe Children's Hospital.
Abstract:
Mycobacterium malmoense is a nontuberculous mycobacteria (NTM), that is uncommon in areas other than Northern Europe. We describe the case of mediastinal lymphadenitis caused by M. malmoense in a 4-year-old boy who has a past medical history of disseminated Bacille de Calmette et Guérin (BCG) infection. He presented with persistent high fever and computed tomography revealed mediastinal lymphadenopathy. We identified M. malmoense by hsp65 gene analysis from a lymph node biopsy sample. We treated him with rifampicin, ethambutol and clarithromycin with reference to the guidelines of the British Thoracic Society. M. malmoense can cause severe infections including mediastinal lymphadenitis in children with susceptibility to acid-fast bacteria (AFB).
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