Tuberc Respir Dis.  2012 May;72(5):452-456.

Disseminated Mycobacterium intracellulare Infection in an Immunocompetent Host

• Kim WY
• Jang SJ
• Ok T
• Kim GU
• Park HS
• Leem J
• Kang BH
• Park SJ
• Oh DK
• Kang BJ
• Lee BY
• Ji WJ
• Shim TS

Abstract

Disseminated Mycobacterium avium complex (MAC) infection can occur in immunocompromised patients, and rarely in immunocompetent subjects. Due to the extensive distribution of the disease, clinical presentation of disseminated MAC may mimic malignancies, and thorough examinations are required in order to make accurate diagnosis. We report a case of disseminated Mycobacterium intracellulare disease in an immunocompetent patient, which involved the lung, lymph nodes, spleen, and multiple bones. F-18 fluorodeoxyglucose positron-emission tomography imaging showed multiple hypermetabolic lesions, which are suggestive of typical hematogenous metastasis. However, there was no evidence of malignancy in serial biopsies, and M. intracellulare was repeatedly cultured from respiratory specimens and bones. Herein, we should know that disseminated infection can occur in the immunocompetent subjects, and it can mimic malignancies.

Keyword

Nontuberculous Mycobacteria; Immunocompetence; Positron-Emission Tomography; Hybridization, Genetic

MeSH Terms

Biopsy
Humans
Hybridization, Genetic
Hydrazines
Immunocompetence
Immunocompromised Host
Lung
Lymph Nodes
Mycobacterium
Mycobacterium avium Complex
Mycobacterium avium-intracellulare Infection
Neoplasm Metastasis
Nontuberculous Mycobacteria
Positron-Emission Tomography
Spleen
Hydrazines

Figure

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  Figure 1 Chest X-ray showed the ill-defined patchy mass opacity with surrounding ground-glass opacity in left mid-lung field.

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  Figure 2 Contrast enhanced computed tomography showed consolidation in the lingual segment of left upper lobe (A) and bilateral meditational lymph nodes swelling (B).

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  Figure 3 Magnetic resonance imaging of the thoracic (A) and lumbar (B) spine showed diffuse heterogenous low signal change with heterogenous enhancement.

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  Figure 4 Maximum intensity projection image of F-18 fluorodeoxyglucose positron-emission tomography on admission showed multifocal hypermetabolic lesions in the left upper lung, lymph nodes, spleen, and multiple bones.

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