Mycobacterium haemophilumin Immunocompromised Patients

Abstract

Mycobacterium haemophilum, a recently described pathogen, can cause an array of symptoms in immunocompromised patients. To date, 90 patients with this infection have been described worldwide. We report our institution's experience with 23 patients who were treated from 1990 through 2000. Fourteen patients had undergone bone marrow transplantation, 5 were infected with human immunodeficiency virus, 3 had hematologic malignancies, and 1 had no known underlying immunosuppression. Clinical syndromes on presentation included skin lesions alone in 13 patients, arthritis or osteomyelitis in 4 patients, and lung disease in 6 patients. Although patients with skin or joint involvement had favorable outcomes, 5 of 7 patients with lung infection died. Prolonged courses of multidrug therapy are required for treatment. A diagnosis of M. haemophilum infection must be considered for any immunocompromised patient for whom acid-fast bacilli are identified in a cutaneous, synovial fluid or respiratory sample or for whom granulomas are identified in any pathological specimen.

High rates of infection and colonization by nontuberculous mycobacteria after allogeneic hematopoietic stem cell transplantation

“…To date, 113 patients with M. haemophilum infection have been described worldwide. In all, 23 (20.4%) cases have occurred at MSKCC, 3,6 including the nine Control and Prevention. 9 patients described above.…”

“…Details regarding these patients have been previously published. 6 All nine received total body irradiation (TBI), chemotherapy, and an allograft depleted of T-cells by soybean agglutination and sheep red blood cell rosetting. Eight of the nine patients also received antithymocyte globulin (ATG).…”

“…Both Mycobacterium tuberculosis and nontuberculous mycobacteria (NTM) are well-described pathogens in alloSCT recipients. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] However, distinguishing infection from colonization by NTM such as Mycobacterium avium complex (MAC) can be difficult, as infection by organisms other than NTM and noninfectious conditions such as graft-versus-host disease (GvHD) can mimic NTM infection in alloSCT recipients. Formal diagnostic criteria for NTM infection ( Figure 1) have been established by the Centers for Disease Control and Prevention (CDC) and the American Thoracic Society but remain controversial.…”

First report of cervicofacial lymphadenitis due to Mycobacterium haemophilum in an immunocompromised adult patient

“…In addition, correlation between in vitro susceptibility test results and treatment response has not been clearly defined [16][17][18]. However, most of the published literature agree that patients should be given a multidrug regimen that include some combination of clarithromycin, ciprofloxacin, and one of the rifamycins for a minimum duration of 12 months [18].…”

Heart transplantation across preformed donor-specific antibody barriers using a perioperative desensitization protocol

“…Infections caused by M. haemophilum will be reported with greater frequency as a result of heightened awareness among physicians and clinical microbiologists and the growing number of immunocompromised patients [14]. As with many emerging infections in immunosuppressed patients, varied clinical presentations will likely be reported.…”