Case Report: Disseminated Mycobacterium intracellulare Infection With More Than 1-Year Follow-Up in a Young Boy With IFNGR1 Deficiency

Abstract

All members of the genus Mycobacterium are collectively labeled as “non-tuberculous mycobacterium” (NTM), with the exception of the Mycobacterium tuberculosis complex and M. leprae. Recently, the incidence of NTM infection and number of cases have been increasing, but their identification remains difficult in some countries. Usually, NTM infections and diseases are associated with primary immunodeficiency diseases (PIDs), and their prognoses can be improved with a timely diagnosis and appropriate treatment. Here, we report a case of a 3-year-old boy with disseminated NTM disease (Mycobacterium intracellulare) and interferon-γ receptor 1 (IFNGR1) deficiency. He presented with skin and soft-tissue disease, disseminated osteomyelitis, and pulmonary disease. Initially, we suspected an infection due to the Bacillus Calmette–Guérin vaccine but later suspected Langerhans cell histiocytosis. Following oral treatment of azithromycin, rifampicin, and ethambutol, his condition improved progressively according to clinical and imaging manifestations. This case highlights the importance of early identification of the pathogen in a timely prescription of specific treatments in PIDs patients. We also discuss our experience of treatment of M. intracellulare disease in patients with IFNGR1 deficiency.

Intestinal nontuberculous mycobacteria infection: A case report

“…[6][7][8][9][10] A recent case reported that a diffuse NTM disease caused by Mycobacterium intracellulare occurred in a child with IFNGR1 deficiency, with a good prognosis after antimycobacterial treatment. [11] A patient diagnosed with septic arthritis was due to NTM infection as Mycobacterium intracellulare was isolated by culture and showed an excellent prognosis with antimycobacterial treatment. [12] This study shows that the clinical application of molecular diagnostic technology plays a crucial role in diagnosing nontuberculous mycobacteriosis and the differential diagnosis with other inflammatory disorders.…”

“…[6–10] A recent case reported that a diffuse NTM disease caused by Mycobacterium intracellulare occurred in a child with IFNGR1 deficiency, with a good prognosis after antimycobacterial treatment. [11] A patient diagnosed with septic arthritis was due to NTM infection as Mycobacterium intracellulare was isolated by culture and showed an excellent prognosis with antimycobacterial treatment. [12]…”

Disseminated mycobacterium avium complex spinal osteomyelitis in a patient with interferon gamma receptor deficiency: A case report

“…These deficiencies include autosomal recessive and autosomal dominant disorders, complete, and partial functional defects, forms in which the surface receptors are dysfunctional, forms in which the surface receptors are absent, and other mechanisms disrupting the function of the IFN-γ receptors. STAT1, JAK1, and gp91 phox deficiencies also impair cellular responses to IFN-γ [ 19 ].…”