Hodgkin Lymphoma after Disseminated Mycobacterium genavense Infection, Germany

Abstract

Mycobacterium genavense infection, a rare nontuberculous mycobacteria infection, occurs in heavily immunocompromised patients (i.e., those with advanced HIV disease, genetic disorders, or acquired immunologic disorders and those undergoing immunosuppressive therapy). We report a case of disseminated M. genavense infection preceding Hodgkin lymphoma in a patient without obvious risk factors for this infection.

Keywords: Germany; Hodgkin lymphoma; Mycobacterium genavense; cervical lymphadenopathy; nontuberculous Mycobacterium; tuberculosis and other mycobacteria; zoonoses.

Figure

Clinical manifestations and radiologic findings in the course of disease in a 23-year-old woman with disseminated M. genavense infection preceding Hodgkin lymphoma, Germany. A) Cervical wound after initial lymph node extirpation. B) Magnetic resonance imaging at the time of initial evaluation. C) Endobronchial view of tracheo-esophageal fistula before positioning of a stent. D) Endobronchial view of the prior tracheo-esophageal fistula after treatment. Whitish scar tissue is seen at the bottom left. E) ¹⁸F-FDG-PET scan at initial evaluation (maximum intensity projection). Cervical lymph node mass is seen, with no pathologic uptake in the abdomen. F) ¹⁸F-FDG-PET scan after 6 months of antibiotic treatment showing reduced uptake. G) ¹⁸F-FDG-PET scan shortly before Hodgkin lymphoma was diagnosed showing new hepatosplenomegaly and lymphadenopathy. H) ¹⁸F-FDG-PET scan after antibiotic and chemotherapy without pathologic enhancement.