Disseminated Mycobacterium genavense presenting as recurrent steroid-responsive mesenteric lymphadenitis
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Updated: Nov 5, 2026

Murine Mesenteric Lymphadenectomy for Selective Disruption of Lymphatic Communication with Region-Specific Gut
Published on: December 30, 2025
Portia Mira1, Nancy L Wengenack1, Mary J Kasten2
1Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.
Background:
Mycobacterium genavense is a rare opportunistic non-tuberculous mycobacterium primarily reported in advanced human immunodeficiency virus infection.
Case Summary:
A 70-year-old woman with systemic lupus erythematosus developed progressive abdominal pain, weight loss, and mesenteric lymphadenitis repeatedly responsive to corticosteroids. Endoscopic biopsies revealed abundant acid-fast bacilli, and molecular testing confirmed the presence of M. genavense. Treatment with azithromycin, ethambutol, and rifabutin led to gradual recovery.
Conclusion:
Steroid-responsive mesenteric inflammation in immunocompromised patients should prompt evaluation for infection, including mycobacteria and other culture-negative microorganisms using molecular diagnostics. This case report highlights the importance of plasma microbial cell-free DNA assays in the identification of fastidious organisms, like M. genavense, and, in some cases, serial testing may be useful to monitor treatment response.
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