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Case Reports
. 2019 Nov 29;8(1):27-30.
doi: 10.4103/JMAU.JMAU_18_19. eCollection 2020 Jan-Mar.

Mycobacterium Avium Complex: A Rare Cause of Pancytopenia in HIV Infection

Kamal Kant Sahu  1 , Ajay Kumar Mishra  1 , Amos Lal  1 , George M Abraham  2   3
Affiliations
Case Reports

Mycobacterium Avium Complex: A Rare Cause of Pancytopenia in HIV Infection

Kamal Kant Sahu et al. J Microsc Ultrastruct. .

Abstract

Opportunistic infections in HIV infection are challenging to diagnose and treat, especially when the prevalence of disease is rare. Mycobacterial infections can have debilitating morbidity and mortality in HIV individuals if prompt diagnosis and treatment is not done. A 33-year-old African-American female presented for the complaints of easy fatigability, unintentional weight loss, and diarrhea of 3-month duration. Initial laboratory results suggested bicytopenia; however, there was an initial delay of a couple of months in evaluation because of her poor compliance. A final diagnosis of HIV with a low CD4 count of 9 cells/mm3 and disseminated Mycobacterium avium complex (MAC) infection was made. She was started on anti-MAC therapy, followed by antiretroviral therapy however soon succumbed to her illness.

Keywords: HIV; Mycobacterium avium complex; pancytopenia.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a) Chest X-ray showing mediastinal fullness. (b) Transverse view of computed tomography pelvis showing hypoechoic lesion with splenomegaly. (c) Transverse view showing mediastinal lymph nodal enlargement
Figure 2
Figure 2
(a) Section from the bone marrow trephine biopsy showing vaguely nodular aggregates of foamy histiocytes along with lymphocytic cell infiltrates. The normal hematopoietic lineage elements are markedly reduced (Hematoxylin and Eosin, ×200). (b) Closer view of the bone marrow trephine biopsy section showing foamy histiocytic cell infiltrates along with lymphocytes and plasma cells (Hematoxylin and Eosin, ×400). (c) Abundant acid-fast bacilli are seen within the histiocytes (Ziehl–Neelsen stain, ×1000). (d) Section from the lymph node biopsy showing effaced nodal architecture with sheets of foamy histiocytes and many lymphocytic cell infiltrates (Hematoxylin and Eosin, ×200). (e) High-power view of the section from the lymph node biopsy showing foamy histiocytes (Hematoxylin and Eosin, ×400). (f) Numerous acid-fast bacilli are seen within the histiocytes (Ziehl–Neelsen stain, ×1000)
Graph 1
Graph 1
Graphical trend in the hematological parameters (hematocrit, platelet count, and leukocyte count)
See this image and copyright information in PMC

References

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