. Krebs T, Zimmerli S, Bodmer T & Lämmle B (Central Hematology Laboratory, Inselspital, University Hospital of Bern; Institute of Medical Microbiology, University of Bern, Bern, Switzerland). Mycobacterium genavense infection in a patient with long‐standing chronic lymphocytic leukaemia (Case Report). J Intern Med 2000; 248: 343–348.
We describe the first case of disseminated infection with Mycobacterium genavense in an HIV‐seronegative patient with a chronic haematological disorder. Our patient, an 80‐year‐old woman, had been under long‐term treatment with chlorambucil (partially in combination with prednisone) for B‐cell chronic lymphocytic leukaemia (B‐CLL). When she developed general fatigue and progressive anaemia, as well as progressive lymphadenopathy and splenomegaly, bone marrow biopsy revealed granulomas with acid‐fast bacilli, and cultures of both bone marrow and blood grew M. genavense. The patient’s CD4+ cell count was approximately 100 µL–1. Treatment with clarithromycin, ethambutol and rifabutin resulted in improvement of anaemia and general health as well as in regression of lymphadenopathy and splenomegaly.