Mycobacterium genavense as a cause of subacute pneumonia in patients with severe cellular immunodeficiency

Abstract

BackgroundMycobacterium genavense is a rare nontuberculous mycobacteria (NTM). Human infections are mostly disseminated in the setting of the AIDS epidemic or the use of aggressive immunosuppressive treatments. M. genavense culture is fastidious, requiring supplemented media. Pulmonary involvement rarely occurs as a primary localization.Cases presentationWe report here two patients with pneumonia as the predominant manifestation of M. genavense infection: one kidney transplanted patient and one HIV-infected patient. Both patients were initially treated with anti-tuberculous drugs before the identification of M. genavense on sputum or broncho-alveolar lavage fluid culture. A four-drug regimen including clarithromycin and rifabutin was started. Gamma interferon has been helpful in addition to antimycobacterial treatment for one patient.ConclusionClinicians should be aware that M. genavense could be the etiologic agent of sub-acute pneumonia mimicking tuberculosis in patients with cellular immunodeficiency status.

Non-tuberculous Mycobacteria isolated from Pulmonary samples in sub-Saharan Africa - A Systematic Review and Meta Analyses

“…kubicae . Although some of these species have also been isolated in other parts of the world from pulmonary samples in patients with chronic bronchitis, pulmonary tuberculosis, sub-acute pneumonia and healed tuberculosis 61 , 62 , it is currently unclear what role they play in the aetiology of pulmonary disease in Africa.…”

Mycobacterium genavense infection in a solid organ recipient: a diagnostic and therapeutic challenge

“…The incidence of M. genavense infection in the Swiss HIV Cohort Study (1990-1992, before introduction of HAART) was found to represent 12.8% of disseminated NTM infections (21). This cohort also demonstrated that the clinical presentation consists of fever (80- SOT recipients with M. genavense infection reported in the literature, 6 patients (the majority) underwent kidney transplantation (4)(5)(6)(9)(10)(11), our currently reported 1 patient had a combined kidney-heart transplantation, 1 patient had a combined kidneypancreas transplantation (12), 2 patients had liver transplantation (9, 10), 1 patient had a lung transplantation (13), and 3 patients had heart transplantation (8,11,14). All patients presented with disseminated disease, and 6 of them died despite treatment.…”

“…M. genavense infections occur rarely in SOT recipients. Of the 14 immunocompromised HIV‐negative SOT recipients with M. genavense infection reported in the literature, 6 patients (the majority) underwent kidney transplantation , our currently reported 1 patient had a combined kidney–heart transplantation, 1 patient had a combined kidney–pancreas transplantation , 2 patients had liver transplantation , 1 patient had a lung transplantation , and 3 patients had heart transplantation . All patients presented with disseminated disease, and 6 of them died despite treatment.…”

“…All patients presented with disseminated disease, and 6 of them died despite treatment. Table 1 shows all reported cases of M. genavense infection in HIV-negative SOT patients (4)(5)(6)(8)(9)(10)(11)(12)(13)(14).…”

Mycobacterium genavense Infections in a Tertiary Hospital and Reviewed Cases in Non-HIV Patients

“…M. genavense often affects the bowel and has less frequently been related to pleuropulmonary involvement [18, 20, 29, 47]. Other less commonly reported localizations are cutaneous, cerebral as a solitary lesion, and genital tract [19, 20, 22].…”