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Mycobacterium genavense as a cause of subacute pneumonia in patients with severe cellular immunodeficiency

B. Rammaert,L. Couderc,E. Rivaud,P. Honderlick,D. Zucman,M. Mamzer,P. Cahen,E. Bille,Marc Lecuit,O. Lortholary,É. Catherinot

Published 2011 in BMC Infectious Diseases

ABSTRACT

BackgroundMycobacterium genavense is a rare nontuberculous mycobacteria (NTM). Human infections are mostly disseminated in the setting of the AIDS epidemic or the use of aggressive immunosuppressive treatments. M. genavense culture is fastidious, requiring supplemented media. Pulmonary involvement rarely occurs as a primary localization.Cases presentationWe report here two patients with pneumonia as the predominant manifestation of M. genavense infection: one kidney transplanted patient and one HIV-infected patient. Both patients were initially treated with anti-tuberculous drugs before the identification of M. genavense on sputum or broncho-alveolar lavage fluid culture. A four-drug regimen including clarithromycin and rifabutin was started. Gamma interferon has been helpful in addition to antimycobacterial treatment for one patient.ConclusionClinicians should be aware that M. genavense could be the etiologic agent of sub-acute pneumonia mimicking tuberculosis in patients with cellular immunodeficiency status.

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