Abstract
This article presents a case of an HIV-infected paediatric patient with an unusual Mycobacterium genavense infection with predominantly abdominal organ involvement.
Highlights
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The first case of M. genavense was described in 1987 in the clinical setting of acquired immunodeficiency syndrome (AIDS);[1] the bacterium is closely related to Mycobacterium simiae.[2]
Older literature refers to the use of clofazimine.[30,31,32]. This drug was used less frequently for the treatment of disseminated non-tuberculous mycobacterial disease after a clinical study found that clofazimine in combination with clarithromycin and ethambutol was associated with increased mortality in disseminated M. avium complex infections in patients with AIDS.[33]
Summary
Lymphadenitis; acid-fast bacilli (AFB) (short morphology); Periodic Acid Schiff (PAS) positive; poorly formed, focal granulomata. Duodenum and Granulomatous duodenitis and colitis; caecum histiocytes packed with acid-fast and PAS positive bacilli (small). Liver: granulomatous hepatitis (moderate to well-formed epitheloid granulomata; scattered intracytoplasmic AFB in portal granulomata); intra-abdominal lymphnode: lymphadenitis; histiocytes filled with acid-fast and weakly PAS positive bacilli. At the time of writing this article (17 months of treatment completed), his clinical response had improved. He was able to tolerate small regular meals with no nausea, vomiting or diarrhoea. His weight gain had been slow ( up to 20 kg) despite nutritional supplementation. The hepatosplenomegaly and abdominal distension had improved markedly, and his HIV remains virologically suppressed
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