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Open Access Highly Accessed Case report

Mycobacterium genavense as a cause of subacute pneumonia in patients with severe cellular immunodeficiency

Blandine Rammaert1, Louis-Jean Couderc2, Elisabeth Rivaud2, Patrick Honderlick3, David Zucman4, Marie-France Mamzer5, Pierre Cahen3, Emmanuel Bille6, Marc Lecuit17, Olivier Lortholary18 and Emilie Catherinot12*

Author Affiliations

1 Université Paris-Descartes, Hôpital Necker-Enfants Malades, Service des Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, Paris, France

2 Université Versailles-Saint Quentin, Hôpital Foch, Service de Pneumologie, Suresnes, France

3 Hôpital Foch, Service de Microbiologie, Suresnes, France

4 Hôpital Foch, Service de Médecine Interne, Suresnes, France

5 Université Paris-Descartes, Hôpital Necker-Enfants malades, Service de Transplantation Rénale, Paris, France

6 Université Paris-Descartes, Hôpital Necker-Enfants malades, Service de Microbiologie, Paris, France

7 Institut Pasteur, Groupe Microorganismes et barrières de l'hôte, Inserm avenir U604, Paris, France

8 Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycologie et Antifongiques, CNRS URA3012, Paris, France

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BMC Infectious Diseases 2011, 11:311  doi:10.1186/1471-2334-11-311

Published: 5 November 2011

Abstract

Background

Mycobacterium genavense is a rare nontuberculous mycobacteria (NTM). Human infections are mostly disseminated in the setting of the AIDS epidemic or the use of aggressive immunosuppressive treatments. M. genavense culture is fastidious, requiring supplemented media. Pulmonary involvement rarely occurs as a primary localization.

Cases presentation

We report here two patients with pneumonia as the predominant manifestation of M. genavense infection: one kidney transplanted patient and one HIV-infected patient. Both patients were initially treated with anti-tuberculous drugs before the identification of M. genavense on sputum or broncho-alveolar lavage fluid culture. A four-drug regimen including clarithromycin and rifabutin was started. Gamma interferon has been helpful in addition to antimycobacterial treatment for one patient.

Conclusion

Clinicians should be aware that M. genavense could be the etiologic agent of sub-acute pneumonia mimicking tuberculosis in patients with cellular immunodeficiency status.