title: Acquired immune-deficiency syndrome with focal onset of Mycobacterium avium infection displaying a histological/genetic pattern of disseminated mycobacteria.
abstract: A 66-year-old man with human immunodeficiency virus (HIV) infection was admitted for treatment of Pneumocystis pneumonia. Upon admission, a tumor mass adjacent to the thoracic descending aorta was revealed on computed tomography. Histology revealed an exudative granuloma with histiocytes packed with numerous acid-fast bacilli. Mycobacterium avium was isolated from the tissue. A genetic examination of the isolates demonstrated this strain to be located in the cluster consisting of strains that cause systemic infection. The patient's baseline CD4+ cell count was 9/μL and the HIV-RNA viral load was 43,800 copies/mL. This case suggests the possibility of a localized onset of disseminated M. avium infection.
authors.affiliation: Department of Infections, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases, Faculty of Medicine, University of the Ryukyus, and Department of Clinical Research, National Hospital Organization, Higashinagoya National Hospital, Japan. kenjihibiya@gmail.com
authors.forename: Kenji
authors.initials: K
authors.lastname: Hibiya
authors.forename: Masao
authors.initials: M
authors.lastname: Tateyama
authors.forename: Masaki
authors.initials: M
authors.lastname: Niimi
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Teruya
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Karimata
authors.forename: Jun
authors.initials: J
authors.lastname: Hirai
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Tokeshi
authors.forename: Shusaku
authors.initials: S
authors.lastname: Haranaga
authors.forename: Daisuke
authors.initials: D
authors.lastname: Tasato
authors.forename: Hideta
authors.initials: H
authors.lastname: Nakamura
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ihama
authors.forename: Attitya
authors.initials: A
authors.lastname: Haroon
authors.forename: Haley L
authors.initials: HL
authors.lastname: Cash
authors.forename: Futoshi
authors.initials: F
authors.lastname: Higa
authors.forename: Akira
authors.initials: A
authors.lastname: Hokama
authors.forename: Kenji
authors.initials: K
authors.lastname: Ogawa
authors.forename: Jiro
authors.initials: J
authors.lastname: Fujita
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology* / Q000473:pathology; D000368:Aged; D015658:HIV Infections / Q000821:virology; D006801:Humans; D008297:Male; D015269:Mycobacterium avium Complex / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D015270:Mycobacterium avium-intracellulare Infection / Q000382:microbiology* / Q000473:pathology; D010802:Phylogeny; D019562:Viral Load