Mycobacterium genavense: una causa infrecuente de lesión cerebral ocupante de espacio

Abstract

Introduction

Patients with advanced HIV/AIDS disease are at high risk to developing opportunistic infections. Non-tuberculous mycobacterias (NTM), as Mycobacterium genavense, has been found to cause disseminated infection in patients with AIDS. These organisms are transmitted through inhalation and ingestion and cause serious infections in both, immunocompromised and immunocompetent hosts. We describe an unusual case of a patient with AIDS who presented with a cerebral mass lesion, which was found to be caused by infection with M. genavense.

Clinical case

A 49-year-old man, with a large history of advanced HIV/AIDS disease, and a background of disseminated infection due to a mycobacteria, not identify, two years before, with digestive tract, bone marrow and central nervous system involvement. He was started on antituberculous treatment extended to NTM. He was discharged but interrupted the controls and the treatment. Several months later, he returned with left omalgia without neurological symptoms. A computed tomography of the brain showed a right temporo-parietal mass with surrounding vasogenic edema, concerning for an abscess. Microbiological examination of the surgical piece showed the development of M. genavense.

Conclusions

We report a case of M. genavense brain abscess in a patient with advanced HIV/AIDS disease. Advanced HIV disease represents the most common risk factor for NTM infections. M. genavense is a very rare etiological agent of brain mass lesions in immunocompromised hosts. Stereotactic brain biopsy or neurosurgical exeresis of the brain abscess followed by the direct and culture examination of the material obtained are necessary to reach the etiological diagnosis and an adequate treatment according to the antibiogram. Additionally, we discuss the microbiology of this organism and review the literature on M. genavense infections.