PDF(Pubmed)
Abstract：
BACKGROUND: Mycobacterium avium complex (MAC) is an uncommon clinical pathogen, especially in the central nervous system (CNS), and carries a poor prognosis. MAC infections commonly present as immune reconstitution disease (IRD) in HIV patients. Herein, we report a case of intracranial infection caused by MAC in an AIDS patient without disseminated MAC (DMAC) and immune reconstitution inflammatory syndrome (IRIS).
METHODS: A 31-year-old HIV-positive male presented us with progressively worsening CNS symptoms, and neuroimaging revealed ring-enhancing lesions. The intracranial lesions worsened after the empirical therapy for toxoplasma encephalitis and fungal infection. Due to the rapid progression of the disease, the patient died. Mycobacterium avium was the only pathogen in brain tissue after cultures and molecular biology tests.
CONCLUSIONS: MAC infection in CNS is challenging to diagnose in HIV patients. Our findings emphasize that obtaining tissue samples and applying molecular biology methods is essential to help diagnose the patient as soon as possible to receive adequate treatment.
METHODS: A 31-year-old HIV-positive male presented us with progressively worsening CNS symptoms, and neuroimaging revealed ring-enhancing lesions. The intracranial lesions worsened after the empirical therapy for toxoplasma encephalitis and fungal infection. Due to the rapid progression of the disease, the patient died. Mycobacterium avium was the only pathogen in brain tissue after cultures and molecular biology tests.
CONCLUSIONS: MAC infection in CNS is challenging to diagnose in HIV patients. Our findings emphasize that obtaining tissue samples and applying molecular biology methods is essential to help diagnose the patient as soon as possible to receive adequate treatment.
摘要：
背景：鸟分枝杆菌复合体（MAC）是一种罕见的临床病原体，尤其是在中枢神经系统（CNS），预后不良。MAC感染通常在HIV患者中表现为免疫重建疾病(IRD)。在这里，我们报告了1例无播散性MAC(DMAC)和免疫重建炎症综合征(IRIS)的AIDS患者由MAC引起的颅内感染。
方法：一名31岁的HIV阳性男性患者的中枢神经系统症状逐渐恶化，和神经影像学显示环增强病变。经验治疗弓形虫脑炎和真菌感染后，颅内病变恶化。由于疾病的快速进展，病人死了。经过培养和分子生物学测试，鸟分枝杆菌是脑组织中唯一的病原体。
结论：中枢神经系统中的MAC感染对HIV患者的诊断具有挑战性。我们的发现强调，获取组织样本并应用分子生物学方法对于帮助患者尽快诊断以接受适当的治疗至关重要。
方法：一名31岁的HIV阳性男性患者的中枢神经系统症状逐渐恶化，和神经影像学显示环增强病变。经验治疗弓形虫脑炎和真菌感染后，颅内病变恶化。由于疾病的快速进展，病人死了。经过培养和分子生物学测试，鸟分枝杆菌是脑组织中唯一的病原体。
结论：中枢神经系统中的MAC感染对HIV患者的诊断具有挑战性。我们的发现强调，获取组织样本并应用分子生物学方法对于帮助患者尽快诊断以接受适当的治疗至关重要。
