Fatal disseminated Mycobacterium smegmatis infection in a child with inherited interferon gamma receptor deficiency.
Mycobacterium smegmatis is a common environmental mycobacterium that was first identified in 1884, yet is a rare pathogen in humans. The few M. smegmatis infections reported to date have been localized and have occurred in association with a primary lesion in otherwise immunocompetent individuals. To our knowledge, no case of disseminated M. smegmatis infection has ever been reported, even in patients with severe immune deficiencies. We report a case of disseminated mycobacterial infection that was diagnosed in a 3-year-old girl. The pathogen was not identified as M. smegmatis until the patient was 6 years old. Her condition gradually worsened, and she died when she was 8 years old despite appropriate antimycobacterial therapy. No other opportunistic infections were documented. Immunological investigations revealed an inherited interferon gamma receptor 1 deficiency. This report identifies M. smegmatis as a new opportunistic agent that may be responsible for disseminated disease in immunocompromised individuals.
Pierre-Audigier
C
C
INSERM U429 and Service de Microbiologie, d'Anatomie Pathologique, and d'Immunologie Pédiatrique, Hôpital Necker-Enfants Malades, Paris, France.
Jouanguy
E
E
Lamhamedi
S
S
Altare
F
F
Rauzier
J
J
Vincent
V
V
Canioni
D
D
Emile
J F
JF
Fischer
A
A
Blanche
S
S
Gaillard
J L
JL
Casanova
J L
JL
D016470:Bacteremia / Q000175:diagnosis / Q000276:immunology* / Q000382:microbiology; D002675:Child, Preschool; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D009164:Mycobacterium Infections / Q000175:diagnosis / Q000276:immunology* / Q000382:microbiology; D009894:Opportunistic Infections / Q000175:diagnosis / Q000276:immunology* / Q000382:microbiology; D017471:Receptors, Interferon / Q000172:deficiency* / Q000235:genetics; D000096743:Interferon gamma Receptor
D017471:Receptors, Interferon; D000096743:Interferon gamma Receptor