An unusual case of fever of unknown origin (Mycobacterium avium complex (MAC) infection of young, immune competent woman)

[Emily]

Paluri S, Khayata M, Hammadah M, Konjeti R, Alraies MC
Connecticut Medicine [2014, 78(9):541-544]




Abstract
Mycobacterium avium complex (MAC) infection is a common complication of the later stages of AIDS. Extrapulmonary infection with MAC in HIV-negative patients is considered uncommon. We report a case of a young female who presented with fever of unknown origin on multiple occasions and failed to be diagnosed with MAC by acid-fast stain initially. Subsequently, the patient presented with pancytopenia due to bone marrow biopsy-proven infection with MAC. The patient was not on any immunosuppressant regimen.

Case Discussion
Mycobacterium avium complex: Mycobacterium avium
complex (MAC) is ubiquitous in the environment and
can be recovered from fresh water, sea water, soil, and
dairy products, as well as from a wide variety of animals,
including chickens, pigs, dogs, cats, and insects.1,2 It can
colonize in immunocompetent hosts easily, but with
only mild pathogenicity.3...
...
host patients with apparent normal immune function.3,4
We encountered a case of bone marrow infection with
MAC, which presented as a fever of unknown origin
and pancytopenia due to bone involvement causing
secondary bone marrow suppression. This case report is
important for two reasons: first, we describe a rare clinical
entity of disseminated MAC to the bone marrow
in a non-HIV patient. Second, we are aware that the
diagnosis was missed in the first-time presentation...

http://connmed.csms.org/i/386836​