The Underestimated Threat—Mycobacterium Genavense Infection: A Case Report
Abstract
:1. Introduction
2. Materials and Methods
3. Case Presentation
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Lin, S.-H.; Lai, C.-C.; Huang, S.-H.; Hung, C.-C.; Hsueh, P.-R. Mycobacterial bone marrow infections at a medical centre in Taiwan, 2001–2009. Epidemiol. Infect. 2013, 142, 1524–1532. [Google Scholar] [CrossRef] [PubMed]
- Park, S.C.; Kang, M.J.; Han, C.H.; Lee, S.M.; Kim, C.J.; Lee, J.M.; Kang, Y.A. Prevalence, incidence, and mortality of nontuberculous mycobacterial infection in Korea: A nationwide population-based study. BMC Pulm. Med. 2019, 19, 1–9. [Google Scholar] [CrossRef] [PubMed]
- Thomson, R.M.; Queensland Mycobacterial Reference Laboratory. Queensland Mycobacterial Reference, Changing epidemiology of pulmonary nontuberculous mycobacteria infections. Emerg. Infect. Dis. 2010, 16, 1576–1583. [Google Scholar] [CrossRef]
- Ricotta, E.E.; Adjemian, J.; Blakney, R.A.; Lai, Y.L.; Kadri, S.S.; Prevots, D.R. Extrapulmonary Nontuberculous Mycobacteria Infections in Hospitalized Patients, United States, 2009–2014. Emerg. Infect. Dis. 2021, 27, 845–852. [Google Scholar] [CrossRef]
- Corbett, C.; Finger, P.; Heiß-Neumann, M.; Bohnert, J.; Eder, I.B.; Eisele, M.; Friesen, I.; Kaasch, A.J.; Kehrmann, J.; Lang, R.; et al. Development of prevalence and incidence of non-tuberculous mycobacteria in German laboratories from 2016 to 2020. Emerg. Microbes Infect. 2023, 12, 2276342. [Google Scholar] [CrossRef]
- Blanc, P.; Dutronc, H.; Peuchant, O.; Dauchy, F.-A.; Cazanave, C.; Neau, D.; Wirth, G.; Pellegrin, J.-L.; Morlat, P.; Mercié, P.; et al. Nontuberculous Mycobacterial Infections in a French Hospital: A 12-Year Retrospective Study. PLoS ONE 2016, 11, e0168290. [Google Scholar] [CrossRef]
- Omori, K.; Kitagawa, H.; Yamaguchi, K.; Sakamoto, S.; Horimasu, Y.; Masuda, T.; Miyamoto, S.; Nakashima, T.; Iwamoto, H.; Fujitaka, K.; et al. Clinical characteristics of extrapulmonary nontuberculous mycobacteria infections in comparison with pulmonary infections: A single-center, retrospective study in Japan. J. Infect. Chemother. 2023, 29, 875–881. [Google Scholar] [CrossRef]
- Zweijpfenning, S.M.H.; Hoefsloot, W.; Ingen, J. Geographic Distribution of Nontuberculous Mycobacteria Isolated from Clinical Specimens: A Systematic Review. Semin. Respir. Crit. Care Med. 2018, 39, 336–342. [Google Scholar] [CrossRef]
- Chen, H.-H.; Lin, C.-H.; Chao, W.-C. Mortality association of nontuberculous mycobacterial infection requiring treatment in Taiwan: A population-based study. Ther. Adv. Respir. Dis. 2022, 16, 17534666221103213. [Google Scholar] [CrossRef]
- Loebinger, M.R.; Quint, J.K.; van der Laan, R.; Obradovic, M.; Chawla, R.; Kishore, A.; van Ingen, J. Risk Factors for Nontuberculous Mycobacterial Pulmonary Disease: A Systematic Literature Review and Meta-Analysis. Chest 2023, 164, 1115–1124. [Google Scholar] [CrossRef]
- Chai, J.; Han, X.; Mei, Q.; Liu, T.; Walline, J.H.; Xu, J.; Liu, Y.; Zhu, H. Clinical Characteristics and Mortality of Non-tuberculous Mycobacterial Infection in Immunocompromised vs. Immunocompetent Hosts. Front. Med. 2022, 9, 884446. [Google Scholar] [CrossRef] [PubMed]
- Pennington, K.M.; Vu, A.; Challener, D.; Rivera, C.G.; Shweta, F.; Zeuli, J.D.; Temesgen, Z. Approach to the diagnosis and treatment of non-tuberculous mycobacterial disease. J. Clin. Tuberc. Other Mycobact. Dis. 2021, 24, 100244. [Google Scholar] [CrossRef] [PubMed]
- Wetzstein, N.; Kessel, J.; Bingold, T.M.; Carney, J.; Graf, C.; Koch, B.F.; Meier, F.; Baumgarten, J.; Küpper-Tetzel, C.P.; Khodamoradi, Y.; et al. High overall mortality of Mycobacterium genavense infections and impact of antimycobacterial therapy: Systematic review and individual patient data meta-analysis. J. Infect. 2022, 84, 8–16. [Google Scholar] [CrossRef] [PubMed]
- Ratnatunga, C.N.; Lutzky, V.P.; Kupz, A.; Doolan, D.L.; Reid, D.W.; Field, M.; Bell, S.C.; Thomson, R.M.; Miles, J.J. The Rise of Non-Tuberculosis Mycobacterial Lung Disease. Front. Immunol. 2020, 11, 303. [Google Scholar] [CrossRef]
- Chindam, A.; Vengaldas, S.; Srigiri, V.R.; Syed, U.; Kilaru, H.; Chenimilla, N.P.; Kilaru, S.C.; Patil, E. Challenges of diagnosing and treating non-tuberculous mycobacterial pulmonary disease [NTM-PD]: A case series. J. Clin. Tuberc. Other Mycobact. Dis. 2021, 25, 100271. [Google Scholar] [CrossRef]
- Griffith, D.E.; Aksamit, T.; Brown-Elliott, B.A.; Catanzaro, A.; Daley, C.; Gordin, F.; Holland, S.M.; Horsburgh, R.; Huitt, G.; Iademarco, M.F.; et al. An Official ATS/IDSA Statement: Diagnosis, Treatment, and Prevention of Nontuberculous Mycobacterial Diseases. Am. J. Respir. Crit. Care Med. 2007, 175, 367–416. [Google Scholar] [CrossRef]
- Lange, C.; Böttger, E.C.; Cambau, E.; E Griffith, D.; Guglielmetti, L.; van Ingen, J.; Knight, S.L.; Santin, M.; E Stout, J.; Tortoli, E.; et al. Consensus management recommendations for less common non-tuberculous mycobacterial pulmonary diseases. Lancet Infect. Dis. 2022, 22, e178–e190. [Google Scholar] [CrossRef]
- Wright, W.F.; Auwaerter, P.G. Fever and Fever of Unknown Origin: Review, Recent Advances, and Lingering Dogma. Open Forum Infect. Dis. 2020, 7, ofaa132. [Google Scholar] [CrossRef]
- Matsumoto, Y.; Kinjo, T.; Motooka, D.; Nabeya, D.; Jung, N.; Uechi, K.; Horii, T.; Iida, T.; Fujita, J.; Nakamura, S. Comprehensive subspecies identification of 175 nontuberculous mycobacteria species based on 7547 genomic profiles. Emerg. Microbes Infect. 2019, 8, 1043–1053. [Google Scholar] [CrossRef]
- Piersimoni, C.; Scarparo, C. Extrapulmonary infections associated with nontuberculous mycobacteria in immunocompetent persons. Emerg. Infect. Dis. 2009, 15, 1351. [Google Scholar] [CrossRef]
- Bottger, E.; Teske, A.; Kirschner, P.; Bost, S.; Hirschel, B.; Chang, H.; Beer, V. Disseminated “Mycobacterium genavense” infection in patients with AIDS. Lancet 1992, 340, 76–80. [Google Scholar] [CrossRef] [PubMed]
- Santos, M.; Gil-Brusola, A.; Escandell, A.; Blanes, M.; Gobernado, M. Mycobacterium genavense Infections in a Tertiary Hospital and Reviewed Cases in Non-HIV Patients. Pathol. Res. Int. 2014, 2014, 371370. [Google Scholar] [CrossRef] [PubMed]
- Hassanzadeh, A.; Hasannezhad, M.; Abbasian, L.; Ghaderkhani, S.; Ameli, F.; Allahdadi, M. Disseminated mycobacterium genavense infection with central nervous system involvement in an HIV patient: A case report and literature review. BMC Infect. Dis. 2024, 24, 437. [Google Scholar] [CrossRef]
- Singh, M.; Heincelman, M. Disseminated Nontuberculous Mycobacterium Presenting as Chronic Diarrhea and Wasting. J. Investig. Med. High Impact Case Rep. 2022, 10, 23247096221101860. [Google Scholar] [CrossRef]
- Schmidt, V.; Köhler, H.; Heenemann, K.; Möbius, P. Mycobacteriosis in Various Pet and Wild Birds from Germany: Pathological Findings, Coinfections, and Characterization of Causative Mycobacteria. Microbiol. Spectr. 2022, 10, e0045222. [Google Scholar] [CrossRef]
- Trauth, J.; Discher, T.; Fritzenwanker, M.; Imirzalioglu, C.; Arnold, T.; Steiner, D.; Richter, E.; Crisponi, L.; Grimbacher, B.; Herold, S. Hodgkin Lymphoma after Disseminated Mycobacterium genavense Infection, Germany. Emerg. Infect. Dis. 2022, 28, 1506–1509. [Google Scholar] [CrossRef]
- Thomsen, V.Ø.; Dragsted, U.B.; Bauer, J.; Fuursted, K.; Lundgren, J. Disseminated Infection with Mycobacterium genavense: A Challenge to Physicians and Mycobacteriologists. J. Clin. Microbiol. 1999, 37, 3901–3905. [Google Scholar] [CrossRef]
- Charles, P.; Lortholary, O.; Dechartres, A.; Doustdar, F.; Viard, J.P.; Lecuit, M.; Gutierrez, M.C.; French Mycobacterium genavense Study Group. Mycobacterium genavense infections: A retrospective multicenter study in France, 1996–2007. Medicine 2011, 90, 223–230. [Google Scholar] [CrossRef]
- Ogata, R.; Kido, T.; Takeda, K.; Nemoto, K.; Heima, R.; Takao, M.; Miyashita, R.; Ozasa, M.; Tokito, T.; Okuno, D.; et al. Disseminated Mycobacterium genavense Infection Mimicking Sarcoidosis: A Case Report and Review of Literature on Japanese Patients. Microorganisms 2023, 11, 2145. [Google Scholar] [CrossRef]
- Denicolò, S.; Laydevant, S.; Fink, J.; Geiger, C.; Pizzini, A.; Sarcletti, M.; Zschocke, J.; Bellmann-Weiler, R.; Weiss, G.; Tancevski, I. Sarcoid-like lesions obfuscating the diagnosis of disseminated Mycobacterium genavense infection in a patient with IL-12Rβ1-associated immunodeficiency. BMC Infect. Dis. 2022, 22, 770. [Google Scholar] [CrossRef]
- Ulrichs, T.; Lefmann, M.; Reich, M.; Morawietz, L.; Roth, A.; Brinkmann, V.; A Kosmiadi, G.; Seiler, P.; Aichele, P.; Hahn, H.; et al. Modified immunohistological staining allows detection of Ziehl–Neelsen-negative Mycobacterium tuberculosis organisms and their precise localization in human tissue. J. Pathol. 2005, 205, 633–640. [Google Scholar] [CrossRef] [PubMed]
- Pfyffer, G.E.; Wittwer, F. Incubation time of mycobacterial cultures: How long is long enough to issue a final negative report to the clinician? J. Clin. Microbiol. 2012, 50, 4188–4189. [Google Scholar] [CrossRef] [PubMed]
- Choi, J.Y.; Sim, B.R.; Park, Y.; Yong, S.H.; Shin, S.J.; Kang, Y.A. Identification of nontuberculous mycobacteria isolated from household showerheads of patients with nontuberculous mycobacteria. Sci. Rep. 2022, 12, 8648. [Google Scholar] [CrossRef]
- Telenti, A.; Marchesi, F.; Balz, M.; Bally, F.; Böttger, E.C.; Bodmer, T. Rapid identification of mycobacteria to the species level by polymerase chain reaction and restriction enzyme analysis. J. Clin. Microbiol. 1993, 31, 175–178. [Google Scholar] [CrossRef]
- Kirschner, P.; Springer, B.; Vogel, U.; Meier, A.; Wrede, A.; Kiekenbeck, M.; Bange, F.C.; Böttger, E.C. Genotypic identification of mycobacteria by nucleic acid sequence determination: Report of a 2-year experience in a clinical laboratory. J. Clin. Microbiol. 1993, 31, 2882–2889. [Google Scholar] [CrossRef]
- Nick, J.A.; Malcolm, K.C.; Hisert, K.B.; Wheeler, E.A.; Rysavy, N.M.; Poch, K.; Caceres, S.; Lovell, V.K.; Armantrout, E.; Saavedra, M.T.; et al. Culture independent markers of nontuberculous mycobacterial (NTM) lung infection and disease in the cystic fibrosis airway. Tuberculosis 2022, 138, 102276. [Google Scholar] [CrossRef]
- Böttger, E.C. Mycobacterium genavense: An emerging pathogen. Eur. J. Clin. Microbiol. Infect. Dis. 1994, 13, 932–936. [Google Scholar] [CrossRef] [PubMed]
- Brown-Elliott, B.A.; Nash, K.A.; Wallace, R.J., Jr. Antimicrobial susceptibility testing, drug resistance mechanisms, and therapy of infections with nontuberculous mycobacteria. Clin. Microbiol. Rev. 2012, 25, 545–582. [Google Scholar] [CrossRef]
- Malhotra, A.M.; Arias, M.; Backx, M.; Gadsby, J.; Goodman, A.; Gourlay, Y.; Milburn, H.; Moncayo-Nieto, O.L.; Shimmin, D.; Dedicoat, M.; et al. Extrapulmonary nontuberculous mycobacterial infections: A guide for the general physician. Clin. Med. 2024, 24, 100016. [Google Scholar] [CrossRef]
- Dumic, I.; Lutwick, L. Successful treatment of rapid growing mycobacterial infections with source control alone: Case series. IDCases 2021, 26, e01332. [Google Scholar] [CrossRef]
- Kobayashi, M.; Tsubata, Y.; Shiratsuki, Y.; Hotta, T.; Hamaguchi, M.; Isobe, T. Nontuberculous Mycobacterium-associated immune reconstitution inflammatory syndrome in a non-HIV immunosuppressed patient. Respirol. Case Rep. 2022, 10, e0918. [Google Scholar] [CrossRef] [PubMed]
- Andréjak, C.; Thomsen, V.Ø.; Johansen, I.S.; Riis, A.; Benfield, T.L.; Duhaut, P.; Sørensen, H.T.; Lescure, F.X.; Thomsen, R.W. Nontuberculous Pulmonary Mycobacteriosis in Denmark Incidence and Prognostic Factors. Am. J. Respir. Crit. Care Med. 2010, 181, 514–521. [Google Scholar] [CrossRef] [PubMed]
- Hayashi, M.; Takayanagi, N.; Kanauchi, T.; Miyahara, Y.; Yanagisawa, T.; Sugita, Y. Prognostic Factors of 634 HIV-Negative Patients with Mycobacterium avium Complex Lung Disease. Am. J. Respir. Crit. Care Med. 2012, 185, 575–583. [Google Scholar] [CrossRef]
- Kotilainen, H.; Valtonen, V.; Tukiainen, P.; Poussa, T.; Eskola, J.; Järvinen, A. Clinical symptoms and survival in non-smoking and smoking HIV-negative patients with non-tuberculous mycobacterial isolation. Scand. J. Infect. Dis. 2010, 43, 188–196. [Google Scholar] [CrossRef]
Baseline Characteristics | Reference Values | ||
---|---|---|---|
Age | 73 years | ||
Gender | Male | ||
Occupation | Pensioner, pigeon fancier | ||
Symptoms | Reoccurring fever, pronounced weakness, pancytopenia, reduced vigilance | ||
Medical history | BMI 31.2 kg/m², rheumatoid arthritis, myocardial infarction, aortic aneurysm, cholecystolithiasis, diverticulosis, splenomegaly, spondylodesis | ||
Family history | None | ||
Medication | Acetylsalicylic acid Prasugrel Bisoprolol Doxycycline Folic acid Methotrexate Leflunomide Prednisolone Oxycodone Pantoprazole Rosuvastatin Spironolactone Tamsulosin | 100 mg/day 10 mg/day 2.5 mg/day 200 mg/day 5 mg/day Paused, 20 mg/week 20 mg/day 20 mg/day 40 mg/day 40 mg/day 20 mg/day 25 mg/day 0.4 mg/day | |
Initial laboratory results | |||
Leucocytes | 2.05 × 103/µL | [3.91–10.9 × 103/µL] | |
Neutrophils | 81.8% | 41–70.7% | |
Lymphocytes | 11.1% | 19.1–47.9% | |
Monocytes | 5.2% | 5.2–15.2% | |
Eosinophils | 1.2% | 0.6–7.6% | |
Basophils | 0.6% | 0.1–1.2% | |
Hemoglobin | 8.1 g/dL | [13.5–16.9 g/dL] | |
Thrombocytes | 101 × 103/µL | [166–308 × 103/µL | |
Bilirubin | 1.6 mg/dL | [<1.2 mg/dL] | |
Serum creatinine | 1.22 mg/dL | [<0.9 mg/dL] | |
C-reactive protein | 3.2 mg/dL | [<0.5 mg/dL] | |
Initial blood pressure | 95/66 mmHg |
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Sonnenberg, J.; Gabriels, G.; Olaru, I.D.; Mühl, S.; Fischer, J.; Pavenstädt, H.; Trebicka, J.; Peiffer, K.-H.; Tepasse, P.-R. The Underestimated Threat—Mycobacterium Genavense Infection: A Case Report. Infect. Dis. Rep. 2025, 17, 60. https://doi.org/10.3390/idr17030060
Sonnenberg J, Gabriels G, Olaru ID, Mühl S, Fischer J, Pavenstädt H, Trebicka J, Peiffer K-H, Tepasse P-R. The Underestimated Threat—Mycobacterium Genavense Infection: A Case Report. Infectious Disease Reports. 2025; 17(3):60. https://doi.org/10.3390/idr17030060
Chicago/Turabian StyleSonnenberg, Jannik, Gert Gabriels, Ioana Diana Olaru, Sebastian Mühl, Julia Fischer, Hermann Pavenstädt, Jonel Trebicka, Kai-Henrik Peiffer, and Phil-Robin Tepasse. 2025. "The Underestimated Threat—Mycobacterium Genavense Infection: A Case Report" Infectious Disease Reports 17, no. 3: 60. https://doi.org/10.3390/idr17030060
APA StyleSonnenberg, J., Gabriels, G., Olaru, I. D., Mühl, S., Fischer, J., Pavenstädt, H., Trebicka, J., Peiffer, K.-H., & Tepasse, P.-R. (2025). The Underestimated Threat—Mycobacterium Genavense Infection: A Case Report. Infectious Disease Reports, 17(3), 60. https://doi.org/10.3390/idr17030060