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[Mycobacterium genavense infection in 2 HIV seropositive patients in Amsterdam]
E J Kuijper1, M de Witte, D W Verhagen
1Universiteit van Amsterdam, Academisch Medisch Centrum, Amsterdam.
Abstract:
Two patients with an HIV-I infection, a man aged 47 with confusion, aphasia and diarrhoea, and a man aged 32 with dysphagia, a non-productive cough and diarrhoea, were diagnosed as having a disseminated Mycobacterium genavense infection. Both had low counts of CD4+ T lymphocytes. They responded to antimycobacterial treatment. M. genavense was recognized in Geneva in the early nineties as a causative agent of disseminated mycobacterial infections in HIV-seropositive patients with poor cellular immunity. The clinical picture resembles that of a generalized infection with M. avium-intracellulare. M. genavense is a slowly growing mycobacterium which can be isolated and identified using enriched nutrient media and molecular-biological techniques. The infection probably begins in the gastrointestinal tract after oral contamination. DNA of M. genavense can be demonstrated in 25% of the intestinal biopsy samples of non-HIV-seropositive patients.
Insights
Disseminated Mycobacterium genavense infection affects HIV-I patients with low CD4+ T lymphocytes. Antimycobacterial treatment proved effective for these disseminated mycobacterial infections.
Area of Science:
- Infectious Diseases
- Immunology
- Microbiology
Background:
- Mycobacterium genavense is recognized as a cause of disseminated infections in HIV-seropositive individuals with compromised cellular immunity.
- The clinical presentation of M. genavense infection often mimics generalized Mycobacterium avium-intracellulare infection.
Observation:
- Two patients with Human Immunodeficiency Virus type 1 (HIV-I) infection presented with disseminated Mycobacterium genavense infection.
- Symptoms included confusion, aphasia, diarrhea, dysphagia, and non-productive cough in a 47-year-old and a 32-year-old male, respectively.
- Both patients exhibited low CD4+ T lymphocyte counts, indicating severe immune deficiency.
Findings:
- Both patients responded positively to antimycobacterial treatment.
- M. genavense is a slow-growing mycobacterium identifiable through enriched media and molecular techniques.
- The infection is presumed to originate in the gastrointestinal tract via oral contamination.
Implications:
- Early recognition and treatment of M. genavense are crucial for managing disseminated infections in immunocompromised patients.
- Understanding the pathogenesis and diagnostic methods for M. genavense can improve patient outcomes.
- Further research into M. genavense prevalence and transmission routes is warranted, especially in at-risk populations.