Abstract
We describe the first case of disseminated infection with Mycobacterium genavense in an HIV-seronegative patient with a chronic haematological disorder. Our patient, an 80-year-old woman, had been under long-term treatment with chlorambucil (partially in combination with prednisone) for B-cell chronic lymphocytic leukaemia (B-CLL). When she developed general fatigue and progressive anaemia, as well as progressive lymphadenopathy and splenomegaly, bone marrow biopsy revealed granulomas with acid-fast bacilli, and cultures of both bone marrow and blood grew M. genavense. The patient's CD4+ cell count was approximately 100 microL(-1). Treatment with clarithromycin, ethambutol and rifabutin resulted in improvement of anaemia and general health as well as in regression of lymphadenopathy and splenomegaly.
MeSH terms
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Aged
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Aged, 80 and over
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Anti-Bacterial Agents / therapeutic use
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Anti-Inflammatory Agents / adverse effects*
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Antibiotics, Antitubercular / therapeutic use
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Antineoplastic Agents, Alkylating / adverse effects*
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Antitubercular Agents / therapeutic use
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Bone Marrow Examination
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Chlorambucil / adverse effects*
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Clarithromycin / therapeutic use
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Drug Therapy, Combination
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Ethambutol / therapeutic use
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Fatigue / microbiology
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Female
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Humans
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Leukemia, Lymphocytic, Chronic, B-Cell / complications*
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Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy*
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Lymphatic Diseases / microbiology
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Mycobacterium Infections, Nontuberculous / diagnosis
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Mycobacterium Infections, Nontuberculous / drug therapy
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Mycobacterium Infections, Nontuberculous / etiology*
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Nontuberculous Mycobacteria / classification*
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Prednisone / adverse effects*
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Rifabutin / therapeutic use
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Splenomegaly / microbiology
Substances
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Anti-Bacterial Agents
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Anti-Inflammatory Agents
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Antibiotics, Antitubercular
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Antineoplastic Agents, Alkylating
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Antitubercular Agents
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Chlorambucil
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Rifabutin
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Ethambutol
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Clarithromycin
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Prednisone