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The Underestimated Threat-Mycobacterium Genavense Infection: A Case Report
Jannik Sonnenberg1, Gert Gabriels2, Ioana Diana Olaru3
1Department of Medicine B for Gastroenterology, Hepatology, Endocrinology and Clinical Infectiology, University Hospital Münster, 48149 Münster, Germany.
Infectious Disease Reports
|June 25, 2025
Summary
A rare extrapulmonary nontuberculous mycobacteria (NTM) infection caused by Mycobacterium genavense was diagnosed in an immunocompromised patient. Prompt diagnosis and tailored therapy are crucial for successful treatment of NTM infections.
Area of Science:
- Infectious Diseases
- Microbiology
- Immunology
Background:
- Nontuberculous mycobacteria (NTM) infections are increasing globally, with varied species distribution.
- These infections disproportionately affect immunocompromised individuals and present with nonspecific symptoms, complicating diagnosis.
- Extrapulmonary NTM infections pose significant diagnostic and therapeutic challenges.
Observation:
- A 73-year-old pigeon fancier presented with recurrent fever and pancytopenia.
- Initial investigations, including blood cultures and serology, were negative, and bone marrow biopsy showed granulomas, suggesting sarcoidosis.
Findings:
- Mycobacterium genavense (M. genavense) was eventually isolated from bone marrow cultures after six weeks.
- The patient received a combination therapy of azithromycin, rifampicin, and ethambutol, and experienced immune reconstitution inflammatory syndrome (IRIS) managed with supportive care.
Implications:
- This case highlights the importance of considering rare NTM in unexplained fevers, especially in immunocompromised patients.
- Prompt mycobacterial testing and targeted antimicrobial therapy are essential for successful treatment and improved outcomes in NTM infections.
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