title: Intraventricular granulomatous mass associated with Mycobacterium haemophilum: A rare central nervous system manifestation in a patient with human immunodeficiency virus infection.
abstract: We report a rare case of Mycobacterium haemophilum presenting as an intraventricular granulomatous mass with loculated hydrocephalus and seizures in a patient with human immunodeficiency virus. M. haemophilum, a slow-growing mycobacteria, causes localized and disseminated disease among immunocompromised hosts. Central nervous system infection with M. haemophilum is extremely rare. Preoperative laboratory testing of our patient for tuberculosis, toxoplasmosis, sarcoidosis and histoplasmosis were negative. Surgical resection of the mass revealed a caseating granuloma that stained positive for acid-fast bacillus suggesting possible tuberculoma. Despite negative testing for tuberculosis, a polymerase chain reaction analysis was ultimately performed from the resected mass which revealed M. haemophilum. To our knowledge, this is the first case of M. haemophilum presenting as an intraventricular mass. We review the clinical manifestations of this pathogen and discuss the medical and surgical management.
authors.affiliation: Department of Neurological Surgery, Rutgers New Jersey Medical School, Suite 8100, 90 Bergen Street, Newark, NJ 07103, USA.
authors.forename: Luke K
authors.initials: LK
authors.lastname: Barr
authors.affiliation: Department of Pathology and Laboratory Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.
authors.forename: Leroy R
authors.initials: LR
authors.lastname: Sharer
authors.affiliation: Division of Infectious Diseases, Rutgers New Jersey Medical School, Newark, NJ, USA.
authors.forename: Erina
authors.initials: E
authors.lastname: Khadka Kunwar
authors.affiliation: Division of Infectious Diseases, Rutgers New Jersey Medical School, Newark, NJ, USA.
authors.forename: Rajendra
authors.initials: R
authors.lastname: Kapila
authors.affiliation: Centers for Disease Control and Prevention, Infectious Diseases Pathology Branch, Atlanta, GA, USA.
authors.forename: Sherif R
authors.initials: SR
authors.lastname: Zaki
authors.affiliation: Centers for Disease Control and Prevention, Infectious Diseases Pathology Branch, Atlanta, GA, USA.
authors.forename: Clifton P
authors.initials: CP
authors.lastname: Drew
authors.affiliation: Centers for Disease Control and Prevention, Infectious Diseases Pathology Branch, Atlanta, GA, USA.
authors.forename: Julu
authors.initials: J
authors.lastname: Bhatnagar
authors.affiliation: Department of Neurological Surgery, Rutgers New Jersey Medical School, Suite 8100, 90 Bergen Street, Newark, NJ 07103, USA. Electronic address: james.liu.md@rutgers.edu.
authors.forename: James K
authors.initials: JK
authors.lastname: Liu
authors.affiliation: Division of Infectious Diseases, Rutgers New Jersey Medical School, Newark, NJ, USA.
authors.forename: Debra
authors.initials: D
authors.lastname: Chew
mesh_terms: D001927:Brain Diseases / Q000382:microbiology*; D002494:Central Nervous System Infections / Q000276:immunology / Q000382:microbiology / Q000473:pathology; D002552:Cerebral Ventricles / Q000382:microbiology / Q000473:pathology; D006099:Granuloma / Q000382:microbiology*; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D009164:Mycobacterium Infections / Q000276:immunology* / Q000473:pathology*; D018393:Mycobacterium haemophilum
keywords: Central nervous system infection; Granuloma; HIV; Hydrocephalus; Intraventricular mass; Mycobacterium haemophilum