Osteomyelitis caused by Mycobacterium haemophilum: successful therapy in two patients with AIDS.
OBJECTIVE
Difficulties involved in diagnosis and response to antimicrobial therapy are described in detail for two cases of biopsy-proven osteomyelitis caused by Mycobacterium haemophilum in AIDS patients.


METHODS
Two large, private teaching hospitals in New York City, New York, USA.


METHODS
A 31-year-old woman with previous diagnoses of candida esophagitis and peripheral neuropathy (patient 1), and a 37-year-old man with Kaposi's sarcoma (patient 2).


METHODS
One patient was treated with a combination of rifampin, ethambutol, clofazimine, and ciprofloxacin, while the other received rifampin, ciprofloxacin and doxycycline. Both patients also received a short course of intravenous amikacin.


METHODS
Disease activity was monitored clinically by observing resolution of skin ulcers, lymphadenopathy, and pain and swelling in areas affected by osteomyelitis.


RESULTS
Both patients experienced complete resolution of signs and symptoms of M. haemophilum infection. Patient 1 was treated for 17 months and remains well after 10 months without therapy. Patient 2 shows no evidence of infection after 14 months of therapy.


CONCLUSIONS
M. haemophilum infection must be considered in the differential diagnosis of osteomyelitis in AIDS patients, although specialized culture techniques are required to isolate and identify this pathogen. Excellent clinical response can be achieved with oral antimicrobial therapy.
Yarrish
R L
RL
Department of Medicine, St Vincent's Hospital and Medical Center of New York, NY 10011.
Shay
W
W
LaBombardi
V J
VJ
Meyerson
M
M
Miller
D K
DK
Larone
D
D
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D000900:Anti-Bacterial Agents; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D009164:Mycobacterium Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D009894:Opportunistic Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D010019:Osteomyelitis / Q000150:complications* / Q000188:drug therapy / Q000209:etiology
D000900:Anti-Bacterial Agents