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Case Reports
. 2024 Aug 3;23(1):68.
doi: 10.1186/s12941-024-00732-0.

Long-term successfull management of recurrent episodes of nontuberculous mycobacterial infection in an apparently healthy Chinese woman

Angelo Roberto Raccagni  1 , Giovanni Mori  2 , Valeria Poletti de Chaurand  3 , Raffaele Dell'Acqua  4 , Daniela Maria Cirillo  2   3 , Chiara Oltolini  4 , Benedetta Mazzi  5 , Francesco Scomazzoni  6 , Antonella Castagna  2   4 , Monica Guffanti  4
Affiliations
Case Reports

Long-term successfull management of recurrent episodes of nontuberculous mycobacterial infection in an apparently healthy Chinese woman

Angelo Roberto Raccagni et al. Ann Clin Microbiol Antimicrob. .

Abstract

Background: Disseminated non-tuberculous mycobacteria (dNTM) infections are mostly reported among individuals with an underlying congenital or acquired immunodeficiency or receiving immunosuppressive treatment, but are rarely documented in otherwise healthy subjects.

Case presentation: We describe a case of recurrent disseminated mycobacterial infection in an apparently immunocompetent Chinese woman. Mycobacterium szulgai and Mycobacterium avium-complex were identified in distinct episodes. Long-term antimycobacterial therapy was administered given the occurrence of recurrent events when off-treatment. Successful management over more than 10 years and immunologic data are reported.

Conclusions: This case-report highlights that dNTM should be suspected also among apparently immunocompetent hosts and that thorough assessment of underling immune-impairments is helpful to define patients' management. Long-term antimycobacterial therapy and close monitoring is required to grant successful outcomes in case of recurrent dNTM infections.

Keywords: Antimycobacterial therapy; IL-12/IFN-γ pathway; Nontuberculous mycobacteria.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
(A) CT scan showing involvement of: right paramediastinal mass (left), lung nodules (middle), lytic lesions of pelvis (right). (B) CT scan showing improvement of: right paramediasting mass (left), lytic lesions of pelvis (right)
Fig. 2
Fig. 2
(A) MRI showing spinal involvement. (B) MRI showing progression of spinal involvement. (C) MRI showing skeletal disease progression in presence of paravertebral pathologic tissue surfacing in the epidural endorachis at D8-D9
Fig. 3
Fig. 3
(A) MRI showing improvement of spinal lesions. (B) MRI showing further improvement of lesions with persistence of D8-D9 enhancement of reduced intensity. (C) MRI showing stable findings
Fig. 4
Fig. 4
MRI and PET scan showing splenic and skeletal involvement
Fig. 5
Fig. 5
MRI and PET scan showing favorable disease response
Fig. 6
Fig. 6
Eosinophils, total IgE and CRP levels over follow-up
See this image and copyright information in PMC

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