Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2019 May 22;19(1):454.
doi: 10.1186/s12879-019-4050-z.

Pathogenicity of Mycolicibacterium phlei, a non-pathogenic nontuberculous mycobacterium in an immunocompetent host carrying anti-interferon gamma autoantibodies: a case report

Satomi Tanaka  1 , Yoshihiko Hoshino  2 , Takuro Sakagami  3 , Hanako Fukano  2 , Yohei Matsui  4 , Osamu Hiranuma  4
Affiliations
Case Reports

Pathogenicity of Mycolicibacterium phlei, a non-pathogenic nontuberculous mycobacterium in an immunocompetent host carrying anti-interferon gamma autoantibodies: a case report

Satomi Tanaka et al. BMC Infect Dis. .

Abstract

Background: Mycolicibacterium phlei (M. phlei) is known to be a non-pathogenic nontuberculous mycobacterium (NTM) which rarely causes diseases in humans. A disseminated NTM infection is mostly caused by the Mycobacterium avium complex (MAC) and is known to develop in immunocompromised hosts, like those with acquired immune deficiency syndrome (AIDS). Here, we report a case of disseminated M. phlei infection in an immunocompetent host carrying anti-interferon gamma (IFN-γ) autoantibodies.

Case presentation: We detected M. phlei in multiple organs of an elderly woman with no significant medical history except positivity for anti-IFN-γ autoantibodies. She tested negative for human immunodeficiency virus (HIV)-1, 2/ Human T-cell leukemia virus type 1 (HTLV-1) antibody. High-resolution computed tomography (HRCT) of the chest demonstrated a nodule in the left S1 + 2 segment, interlobular septal thickening, multi lymphadenopathy, and osteolysis. A maximum intensity projection image following fluorodeoxyglucose-positron emission tomography (FDG-PET) revealed multifocal hypermetabolic lesions in the nodule and all the swollen lymph nodes seen in HRCT. FDG also accumulated in multiple bones. Advanced primary lung cancer was suspected, and biopsies of each lesion were performed. The pathology revealed caseating granuloma, positive for acid-fast bacteria, and DNA sequencing of the acid-fast bacteria confirmed the organism to be M. phlei. The patient also tested positive for anti-IFN-γ autoantibodies. Based on these findings, she was diagnosed with disseminated M. phlei infection, with anti-IFN-γ autoantibodies.

Conclusions: Though known to be non-pathogenic, we show that M. phlei can be pathogenic like the MAC in immunocompetent individuals carrying anti-IFN-γ autoantibodies.

Keywords: Autoantibody; Disseminated infection; Interferon gamma; M. phlei.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
A maximum intensity projection image following fluorodeoxyglucose-positron emission tomography (FDG-PET) revealed multifocal hypermetabolic lesions in the nodule in the left S1 + 2 segment, interlobular septal thickening in the left lower lobe, lymphadenopathy of the left hilar, mediastinal, supraclavicular, and posterior cervical lymph nodes. FDG also accumulated in the anterior spinal cord, sacrum, iliac bone, pubic bone, ischium, sternum, scapula, ribs, clavicle, and thigh bone
Fig. 2
Fig. 2
Following the completion of treatment in 26 months, her ESR levels normalized
See this image and copyright information in PMC

References

    1. Browne SK, Burbelo PD, Chetchotisakd P, Suputtamongkol Y, Kiertiburanakul S, Shaw PA, Kirk JL, Jutivorakool K, Zaman R, Ding L, et al. Adult-onset immunodeficiency in Thailand and Taiwan. N Engl J Med. 2012;367(8):725–734. doi: 10.1056/NEJMoa1111160. - DOI - PMC - PubMed
    1. Aguilar JL, Sanchez EE, Carrillo C, Alarcon GS, Silicani A. Septic arthritis due to Mycobacterium phlei presenting as infantile Reiter's syndrome. J Rheumatol. 1989;16(10):1377–1378. - PubMed
    1. Spiegl PV, Feiner CM. Mycobacterium phlei infection of the foot: a case report. Foot Ankle Int. 1994;15(12):680–683. doi: 10.1177/107110079401501211. - DOI - PubMed
    1. Paul E, Devarajan P. Mycobacterium phlei peritonitis: a rare complication of chronic peritoneal dialysis. Pediatr Nephrol. 1998;12(1):67–68. doi: 10.1007/s004670050407. - DOI - PubMed
    1. Karnam S, Alla VM, Kwon J, Harbert T, Sharma A, Airey K, Mooss A. Mycobacterium phlei, a previously unreported cause of pacemaker infection: thinking outside the box in cardiac device infections. Cardiol J. 2011;18(6):687–690. doi: 10.5603/CJ.2011.0034. - DOI - PubMed

Publication types

MeSH terms