PMID- 31227383
OWN - NLM
STAT- MEDLINE
DCOM- 20200330
LR  - 20200330
IS  - 1437-7780 (Electronic)
IS  - 1341-321X (Linking)
VI  - 25
IP  - 12
DP  - 2019 Dec
TI  - Splenic infarction complicated with immune reconstitution inflammatory syndrome 
      due to disseminated Mycobacterium genavense infection in a patient infected with 
      human immunodeficiency virus.
PG  - 1060-1064
LID - S1341-321X(18)30380-5 [pii]
LID - 10.1016/j.jiac.2019.05.023 [doi]
AB  - Mycobacterium genavense (M. genavense) is one of the most fastidious, difficult 
      to culture Mycobacterium species. Patients infected with human immunodeficiency 
      virus (HIV) may develop immune reconstitution inflammatory syndrome (IRIS) due to 
      disseminated M. genavense infection as well as disseminated M. avium and 
      intracellulare complex infection. Consensus regarding treatment of IRIS due to 
      disseminated mycobacterium infection has not yet been obtained, although systemic 
      steroid therapy has been recommended in recent guidelines. Here we report the 
      case of a 48-year-old Japanese man diagnosed with HIV and disseminated 
      M. genavense infection. His initial CD4-positive T cell count was 3/muL, and his 
      HIV1-RNA viral load was 13,000 copies/mL. He developed IRIS due to disseminated 
      M. genavense infection after two weeks of receiving antiretroviral agents. The 
      patient's serum alkaline phosphatase level, as a barometer of disseminated 
      M. genavense infection in this case, was difficult to control with several 
      anti-mycobacterial agents, although his fever was improved by non-steroidal 
      anti-inflammatory drugs. About five weeks after the onset of IRIS, the patient 
      developed acute left upper quadrant pain and was diagnosed with splenic 
      infarction by contrast-enhanced computed tomography. After the splenic 
      infarction, the patient's serum alkaline phosphatase level decreased without 
      systemic steroid therapy or anticoagulant agents, and his left upper quadrant 
      pain improved naturally within a few days. This case suggests that IRIS due to 
      disseminated M. genavense infection can complicate splenic infarction in patients 
      with HIV, and splenic infarction could improve the IRIS due to disseminated 
      M. genavense infection.
CI  - Copyright (c) 2019 Japanese Society of Chemotherapy and The Japanese Association 
      for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
FAU - Hosoda, Tomohiro
AU  - Hosoda T
AD  - Department of Infectious Disease, Kawasaki Municipal Kawasaki Hospital, Japan. 
      Electronic address: ottotto723@gmail.com.
FAU - Sakamoto, Mitsuo
AU  - Sakamoto M
AD  - Department of Infectious Disease, Kawasaki Municipal Kawasaki Hospital, Japan.
FAU - Ohkusu, Kiyofumi
AU  - Ohkusu K
AD  - Department of Microbiology, Tokyo Medical University, Japan.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20190618
PL  - Netherlands
TA  - J Infect Chemother
JT  - Journal of infection and chemotherapy : official journal of the Japan Society of 
      Chemotherapy
JID - 9608375
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - Mycobacterium genavense
SB  - IM
MH  - AIDS-Related Opportunistic Infections/*complications/drug therapy/immunology
MH  - Anti-Bacterial Agents/therapeutic use
MH  - Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/complications/drug 
      therapy/immunology/*microbiology
MH  - Male
MH  - Middle Aged
MH  - Mycobacterium/immunology/*isolation & purification
MH  - Mycobacterium Infections, Nontuberculous/*complications/drug 
      therapy/immunology/microbiology
MH  - Spleen/blood supply/diagnostic imaging
MH  - Splenic Infarction/diagnostic imaging/*immunology
MH  - Tomography, X-Ray Computed
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Human immunodeficiency virus
OT  - Immune reconstitution inflammatory syndrome
OT  - Mycobacterium genavense
OT  - Splenic infarction
EDAT- 2019/06/23 06:00
MHDA- 2020/03/31 06:00
CRDT- 2019/06/23 06:00
PHST- 2018/10/08 00:00 [received]
PHST- 2019/04/11 00:00 [revised]
PHST- 2019/05/24 00:00 [accepted]
PHST- 2019/06/23 06:00 [pubmed]
PHST- 2020/03/31 06:00 [medline]
PHST- 2019/06/23 06:00 [entrez]
AID - S1341-321X(18)30380-5 [pii]
AID - 10.1016/j.jiac.2019.05.023 [doi]
PST - ppublish
SO  - J Infect Chemother. 2019 Dec;25(12):1060-1064. doi: 10.1016/j.jiac.2019.05.023. 
      Epub 2019 Jun 18.