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Mycobacterium simiae infection in Israeli patients with AIDS
1Department of Internal Medicine C, Beilinson Medical Center, Petach Tikvah, Israel.
Summary
Mycobacterium simiae, an environmental bacterium, caused fatal infections in two Israeli patients with AIDS and hemophilia. Clinicians should consider this rare pathogen in immunocompromised individuals in endemic areas.
Area of Science:
- Microbiology
- Infectious Diseases
- Immunocompromised Hosts
Background:
- Mycobacterium simiae is an environmental mycobacterium rarely linked to human disease.
- In Israel, M. simiae is frequently isolated from clinical samples, often colonizing damaged lungs.
- Previous reports documented only two AIDS patients with M. simiae coinfection, both with Mycobacterium avium complex.
Observation:
- Two Israeli patients with AIDS secondary to hemophilia presented with prolonged, antibiotic-unresponsive fevers.
- One patient exhibited cavitary pulmonary infiltrates.
- M. simiae was identified in blood cultures from both patients and in sputum and bone marrow from one.
Findings:
- The identity of M. simiae was confirmed by three reference laboratories.
- Both patients succumbed to disseminated M. simiae infection.
- This study highlights M. simiae as a potential cause of severe, fatal infections in specific patient populations.
Implications:
- The findings suggest M. simiae should be considered in the differential diagnosis of febrile illnesses in AIDS patients, particularly in regions where M. simiae is prevalent.
- Early recognition and appropriate diagnostic workup are crucial for managing M. simiae infections in immunocompromised individuals.
- This underscores the importance of considering atypical mycobacterial infections in the evolving landscape of AIDS-related opportunistic infections.