Mycobacterium genavense infection in a patient with long-standing chronic lymphocytic leukaemia.
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 microL(-1). Treatment with clarithromycin, ethambutol and rifabutin resulted in improvement of anaemia and general health as well as in regression of lymphadenopathy and splenomegaly.
Krebs
T
T
Central Hematology Laboratory, Inselspital, University Hospital of Bern, Switzerland.
Zimmerli
S
S
Bodmer
T
T
Lämmle
B
B
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects*; D000995:Antitubercular Agents / Q000627:therapeutic use; D001856:Bone Marrow Examination; D002699:Chlorambucil / Q000009:adverse effects*; D017291:Clarithromycin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004977:Ethambutol / Q000627:therapeutic use; D005221:Fatigue / Q000382:microbiology; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications* / Q000188:drug therapy*; D008206:Lymphatic Diseases / Q000382:microbiology; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D009170:Nontuberculous Mycobacteria / Q000145:classification*; D011241:Prednisone / Q000009:adverse effects*; D017828:Rifabutin / Q000627:therapeutic use; D013163:Splenomegaly / Q000382:microbiology
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D000904:Antibiotics, Antitubercular; D018906:Antineoplastic Agents, Alkylating; D000995:Antitubercular Agents; D002699:Chlorambucil; D017828:Rifabutin; D004977:Ethambutol; D017291:Clarithromycin; D011241:Prednisone