A young female patient with anorexia nervosa complicated by Mycobacterium szulgai pulmonary infection.
OBJECTIVE
Pulmonary infection with a rare atypical mycobacterium, Mycobacterium szulgai, was discovered during the treatment of anorexia nervosa in a 21-year-old Japanese woman without preexisting pulmonary disease. She had a long history of low body weight below 35 kg.


METHODS
On admission, she was examined. She weighed 23 kg and presented with hypoproteinemia, decreased levels of rapid turnover proteins, liver dysfunction, and decreased serum level of insulin-like growth factor-I.


RESULTS
Although she had had neither clinical symptom specific for mycobacterium pulmonary infection nor inflammatory data, a chest roentgenogram showed an infiltrative shadow with cavity formation in the right upper lung field. Isolated bacteria from sputum was acid-fast bacilli and identified as M. szulgai using the DNA-DNA hybridization method.


CONCLUSIONS
In anorexia nervosa patients with a long history of severe malnutrition, special attention must be paid to the possibility of opportunistic infections, even in the absence of symptoms or inflammatory data.
Hotta
Mari
M
Health Services Center, National Graduate Institute For Policy Studies, 2-2 Wakamatsu-cho, Shinjuku-ku, Tokyo 162-8677, Japan. marihs@grips.ac.jp
Minami
Yuichiro
Y
Itoda
Ichiro
I
Yoshimori
Kozo
K
Takano
Kazue
K
D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications*; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000209:etiology* / Q000382:microbiology*; D009164:Mycobacterium Infections / Q000150:complications* / Q000382:microbiology*; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification*; D009894:Opportunistic Infections / Q000150:complications* / Q000382:microbiology*