title: Chiasmitis caused by Mycobacterium haemophilum in an immunocompromised adult.
abstract: We report a case of chiasmitis caused by a rare nontuberculous mycobacterium in an immunocompromised patient. A 44-year-old man with a history of AIDS presented with recurrent vision loss and headache. Magnetic resonance imaging (MRI) demonstrated an enhancing mass involving the optic chiasm. Histopathologic and microbiological evaluation revealed infection with Mycobacterium haemophilum. While combination antimicrobial and steroid therapy contributed to improvement in his vision, the patient's symptoms recurred. Follow-up MRI showed extension of infection to the hypothalamus and leptomeninges, indicative of basilar meningitis. MRI is a valuable tool for early diagnosis of chiasmitis as well as for monitoring infection progression and treatment response.
authors.affiliation: Albert Einstein College of Medicine, Bronx, NY, USA. Electronic address: soganij@gmail.com.
authors.forename: Julie
authors.initials: J
authors.lastname: Sogani
authors.affiliation: Department of Radiology, Weill Cornell Medical College at New York-Presbyterian Hospital, New York, NY, USA.
authors.forename: Jana
authors.initials: J
authors.lastname: Ivanidze
authors.affiliation: Department of Radiology, Weill Cornell Medical College at New York-Presbyterian Hospital, New York, NY, USA.
authors.forename: C Douglas
authors.initials: CD
authors.lastname: Phillips
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D015818:Eye Infections, Bacterial / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology; D006801:Humans; D016867:Immunocompromised Host; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009164:Mycobacterium Infections / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology; D018393:Mycobacterium haemophilum / Q000302:isolation & purification*; D009897:Optic Chiasm / Q000382:microbiology / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology; D012008:Recurrence
keywords: Chiasmitis; MRI; Mycobacterium haemophilum