title: [Multiple infectious intracranial lesions of Mycobacterium genavense in an immunocompromised patient].
abstract: Nontuberculous mycobacteria rarely infect the central nervous system. Recently, Mycobacterium genavense, nontuberculous mycobacterium (NTM), has been identified as a significant pathogen in patients. In this report, we describe multiple intracranial lesions caused by M. genavense in an immunocompromised host. A 50-year-old man presented with dysarthria, aphasia, and right hemiparesis. He had a primary immunodeficiency and a M. genavense infection in the thoracic and abdominal lymph nodes. Magnetic resonance imaging revealed multiple intracranial masses in the subcortical regions with extensive perifocal edema. Laboratory investigations and cultures of cerebrospinal fluid provided no evidence of disseminated infection. We obtained a biopsy sample via a small craniotomy using neuronavigation, and NTM infection was confirmed on analysis of the specimen. He was treated with antimycobacterial agents, and the clinical symptoms and radiological findings improved. Although a surgical procedure bears the potential risk of infection, especially in an immunocompromised patient, a brain biopsy was necessary for definitive diagnosis in this case and it aided in the administration of appropriate treatment.
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine, Hokkaido University, and Department of Surgical Pathology, Hokkaido University Hospital, Hokkaido, Japan.
authors.forename: Haruto
authors.initials: H
authors.lastname: Uchino
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Terasaka
authors.forename: Shigeru
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Kagari
authors.initials: K
authors.lastname: Kawai
authors.forename: Kanako
authors.initials: K
authors.lastname: Kubota
authors.forename: Shinji
authors.initials: S
authors.lastname: Ooe
authors.forename: Kiyohiro
authors.initials: K
authors.lastname: Houkin
mesh_terms: D001921:Brain / Q000473:pathology; D003952:Diagnostic Imaging; D004660:Encephalitis / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous