title: Mycobacterium xenopi infection masquerading as pulmonary tuberculosis in two patients infected with the human immunodeficiency virus.
abstract: Mycobacterium xenopi infections have rarely been reported among patients infected with the human immunodeficiency virus (HIV). We recently treated two HIV-infected men, neither of whom had a history of pulmonary disease or AIDS-defining conditions, and who had M. xenopi lung infections. Both patients presented with night sweats, cough, and pleuritic chest pain. Chest radiographs showed an upper-lobe nodule in the first patient and a perihilar cavitary infiltrate in the second patient. Both patients were initially believed to have pulmonary tuberculosis and were treated accordingly; however, only M. xenopi grew on cultures of multiple respiratory specimens. This diagnosis was confirmed by cultures of biopsied lung tissue from the first patient and of fluid from a peritracheal abscess in the second patient. Both patients' clinical conditions improved after multidrug therapy (isoniazid, rifampin, pyrazinamide, ethambutol, and ciprofloxacin in the first case; isoniazid, rifampin, and pyrazinamide in the second case). The second patient's condition improved despite in vitro resistance of his isolate to isoniazid and rifampin.
authors.affiliation: Division of Infectious Diseases, University of Rochester Medical Center, New York, USA.
authors.forename: H M
authors.initials: HM
authors.lastname: Jacoby
authors.forename: T M
authors.initials: TM
authors.lastname: Jiva
authors.forename: D A
authors.initials: DA
authors.lastname: Kaminski
authors.forename: L A
authors.initials: LA
authors.lastname: Weymouth
authors.forename: A C
authors.initials: AC
authors.lastname: Portmore
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis*; D000328:Adult; D006801:Humans; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis*; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*