Abstract
The present report describes a case of chronic diarrhea with several ulcers in the ascending colon in a 47-yearold woman who immigrated to Canada from the Phillipines. A biopsy from affected colon revealed caseating granulomas and culture grew mycobacterium avium subspecies. Polymerase chain reaction from the colonic biopsy specimen confirmed the presence of mycobacterium avium subspecies that was subsequently identified by hsp65 sequence to be mycobacterium avium hominissuis (MAH). Anti-mycobacterial therapy was started but discontinued by the patient. After 6 months a repeat colonoscopy was macroscopically normal and no granulomas could be seen on biopsies taken from normal appearing colonic tissue. The epidemiological features, host-range and laboratory identification of this unusual organism are discussed.
Highlights
Mycobacterium avium complex includes four subspecies: M. avium subsp. avium, M. avium subsp. silvaticum, M. avium subsp
A 47 years old woman presented to the gastroenterology clinic for evaluation of mild long-standing intermittent diarrhea
The clinical course, resolution of symptoms and disappearance of colonic ulcers without anti-mycobacterial therapy suggest that this organism may cause a transient infection
Summary
Mycobacterium avium complex includes four subspecies: M. avium subsp. avium, M. avium subsp. silvaticum, M. avium subsp. Hominissuis was associated with digestive tract pathology including mesenteric lymphadenitis; farm animals including pigs and cattle in Uganda, dogs in Germany with mesenteric lymphadenitis and in a pet parrot with gastrointestinal lesions [5,6,7,8,9,10]. These observations suggest an oral route of infection and the ingestion of contaminated water, food, or fomites. MAH was the most common isolated mycobacterium accounting for 53 of the 67. The organism is thought to be acquired through the gastrointestinal tract, isolation from stools is not necessarily associated with disease causation
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