Difficulty in diagnosing intracranial infection caused by Mycobacterium avium in an AIDS patient: case report and review of the literature.

IF 2.4 3区医学 Q2 PATHOLOGY

Diagnostic Pathology Pub Date : 2024-07-09 DOI:10.1186/s13000-024-01515-z

Mengyan Wang, Yahui Cui, Jinchuan Shi, Jun Yan

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引用次数: 0

Abstract

Background: Mycobacterium avium complex (MAC) is an uncommon clinical pathogen, especially in the central nervous system (CNS), and carries a poor prognosis. MAC infections commonly present as immune reconstitution disease (IRD) in HIV patients. Herein, we report a case of intracranial infection caused by MAC in an AIDS patient without disseminated MAC (DMAC) and immune reconstitution inflammatory syndrome (IRIS).

Case presentation: A 31-year-old HIV-positive male presented us with progressively worsening CNS symptoms, and neuroimaging revealed ring-enhancing lesions. The intracranial lesions worsened after the empirical therapy for toxoplasma encephalitis and fungal infection. Due to the rapid progression of the disease, the patient died. Mycobacterium avium was the only pathogen in brain tissue after cultures and molecular biology tests.

Conclusion: MAC infection in CNS is challenging to diagnose in HIV patients. Our findings emphasize that obtaining tissue samples and applying molecular biology methods is essential to help diagnose the patient as soon as possible to receive adequate treatment.

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艾滋病患者分枝杆菌引起的颅内感染诊断困难：病例报告和文献综述。

背景：禽分枝杆菌复合体（MAC）是一种不常见的临床病原体，尤其是在中枢神经系统（CNS）中，其预后较差。MAC 感染通常表现为 HIV 患者的免疫重建疾病（IRD）。在此，我们报告了一例由 MAC 引起的艾滋病患者颅内感染病例，该病例无播散性 MAC（DMAC）和免疫重建炎症综合征（IRIS）：一名31岁的HIV阳性男性患者因中枢神经系统症状逐渐加重前来就诊，神经影像学检查发现了环形强化病变。在对弓形虫脑炎和真菌感染进行经验性治疗后，颅内病变加重。由于病情进展迅速，患者最终死亡。经过培养和分子生物学检测，分枝杆菌是脑组织中唯一的病原体：结论：在艾滋病患者中诊断中枢神经系统的 MAC 感染具有挑战性。我们的研究结果强调，获取组织样本并应用分子生物学方法对帮助尽快诊断患者以获得适当治疗至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diagnostic Pathology 医学-病理学

CiteScore

4.60

自引率

0.00%

发文量

审稿时长

1 months

期刊介绍： Diagnostic Pathology is an open access, peer-reviewed, online journal that considers research in surgical and clinical pathology, immunology, and biology, with a special focus on cutting-edge approaches in diagnostic pathology and tissue-based therapy. The journal covers all aspects of surgical pathology, including classic diagnostic pathology, prognosis-related diagnosis (tumor stages, prognosis markers, such as MIB-percentage, hormone receptors, etc.), and therapy-related findings. The journal also focuses on the technological aspects of pathology, including molecular biology techniques, morphometry aspects (stereology, DNA analysis, syntactic structure analysis), communication aspects (telecommunication, virtual microscopy, virtual pathology institutions, etc.), and electronic education and quality assurance (for example interactive publication, on-line references with automated updating, etc.).