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Nontuberculous mycobacterial infection of the central nervous system in patients with AIDS

C N Jacob1, S S Henein, A E Heurich

  • 1School of Medicine, State University of New York-Health Science Center, Brooklyn.

Southern Medical Journal
|June 1, 1993
PubMed

Insights

Nontuberculous mycobacteria (NTM) meningitis is rare in AIDS patients. Mycobacterium avium-intracellular (MAI) in cerebrospinal fluid (CSF) of AIDS patients indicates widespread dissemination and a 67% mortality rate.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Immunology

Background:

  • Nontuberculous mycobacteria (NTM) infections are common in individuals with Acquired Immunodeficiency Syndrome (AIDS).
  • NTM meningitis is an infrequent but severe complication in this patient population.

Purpose of the Study:

  • To investigate the incidence, clinical features, and outcomes of NTM meningitis in patients with AIDS.
  • To determine the prognostic significance of Mycobacterium avium-intracellulare (MAI) detection in cerebrospinal fluid (CSF) of AIDS patients.

Main Methods:

  • Retrospective review of hospital records over 11 years.
  • Identification of patients with positive CSF cultures for NTM.
  • Analysis of clinical data, CSF analysis, and patient outcomes.

Main Results:

  • 16 cases of NTM meningitis were identified in AIDS patients.
  • 15 cases were caused by Mycobacterium avium-intracellulare (MAI), one by Mycobacterium fortuitum.
  • MAI meningitis cases showed widespread dissemination, AIDS-related risk factors, and 67% in-hospital mortality.
  • CSF analysis in MAI cases revealed mild pleocytosis with lymphocyte predominance, normal protein, and glucose.

Conclusions:

  • MAI detection in CSF of AIDS patients signifies a poor prognosis with high mortality.
  • NTM meningitis, particularly MAI, represents a critical opportunistic infection in advanced HIV disease.

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