Cervical Mycobacterium genavense infection in a patient with lymphadenitis and previously unknown anti-IFN-γ IgG autoantibodies.

IF 5.4 2区医学 Q1 INFECTIOUS DISEASES

Infection Pub Date : 2025-05-16 DOI:10.1007/s15010-025-02539-3

Ioannis Michaelides, Stilla Bauernfeind, Uwe Kölsch, Florian Hitzenbichler, Christopher Bohr, Constantin A Hintschich

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引用次数: 0

Abstract

Background: Infections with atypical mycobacteria are rare and sometimes difficult to correctly diagnose. In many cases underlying diseases such immune deficiency can promote these infections.

Case presentation: A 43-year-old male of Southeast Asian origin presented to our tertiary care hospital with persistent cervical lymphadenopathy non-responsive to antibiotics. Imaging suggested malignancy, but a biopsy did not confirm this suspicion. PCR diagnostics identified Mycobacterium genavense and further immunological testing revealed an acquired adult-onset immunodeficiency due to neutralizing anti-IFN-γ autoantibodies (nAIGA), explaining both the current infection and previous pleural empyema. The patient responded well to triple antimycobacterial therapy, with no recurrence or novel infection after almost two years.

Conclusions: Our case highlights the importance of considering underlying immunodeficiencies and the patient's geographic origin in the diagnosis of rare infections.

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宫颈结核分枝杆菌感染的淋巴结炎患者和以前未知的抗ifn -γ IgG自身抗体。

背景：非典型分枝杆菌感染是罕见的，有时难以正确诊断。在许多情况下，免疫缺陷等潜在疾病可促进这些感染。病例介绍：一名43岁东南亚裔男性，因持续颈部淋巴结病变对抗生素无反应而来到我们的三级护理医院。影像学提示为恶性，但活检未证实这种怀疑。PCR诊断鉴定为属源性分枝杆菌，进一步的免疫学检测显示，由于中和抗ifn -γ自身抗体（nAIGA），获得性成人发病免疫缺陷，解释了当前感染和既往胸膜脓胸。患者对三联抗真菌治疗反应良好，近两年后无复发或新感染。结论：我们的病例强调了在诊断罕见感染时考虑潜在免疫缺陷和患者地理来源的重要性。

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

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.