Disseminated Infection With Mycobacterium genavense in the Setting of HIV Infection Misdiagnosed as Sarcoidosis

Mycobacterium genavense was first identified in a patient with HIV. Here, we describe a 40-year-old man with prolonged fever and mediastinal and abdominal lymphadenopathy, who was initially misdiagnosed with sarcoidosis. A molecular study was conducted after mycobacterium was isolated from a lymph node biopsy, leading to the identification of M. genavense. The identification of this microbe, along with recurrent oral candidiasis and varicella skin lesions, raised suspicion of an immunodeficiency disorder, which ultimately resulted in an HIV diagnosis. Concurrently, the patient experienced polyradiculopathy caused by cytomegalovirus. This case highlights that after identifying a granuloma in tissue, a comprehensive investigation to exclude infectious causes using microbiological and molecular methods is crucial.