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CASE REPORT article
Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
Volume 12 - 2024 |
doi: 10.3389/fpubh.2024.1387722
This article is part of the Research Topic Nontuberculous Mycobacterial Infections in Animals And Humans: Pathogenesis, Diagnosis, Prevention, Treatment, And Epidemiology View all 12 articles
Case report: Mycobacteria chimaera-induced lymph node infection in a patient with chronic myeloproliferative neoplasm misdiagnosed as tuberculous lymphadenitis
Provisionally accepted- 1 Clinical Laboratory, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, China
- 2 Department of Infectious Diseases, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, China
- 3 Dongyang Hospital of Wenzhou Medical University, Dongyang, China
- 4 Department of Biomedical Sciences Laboratory, Dongyang Hospital of Wenzhou Medical University, Dongyang, China
Herein, we report a case of lymphadenitis caused by Mycobacterium chimaera. A 54-year-old woman with chronic myeloproliferative neoplasm was admitted to the hospital with cervical lymphadenopathy. After preliminary exclusion of various diseases such as lymphoma, Epstein-Barr virus infection, and autoimmune disease, a lymph node biopsy specimen showed epithelioid granulomatous lymphadenitis with caseous necrosis, epithelial-like cells, multinucleated giant cells as seen in tuberculosis. Although Mycobacterium tuberculosis was never isolated, diagnostic antituberculosis treatment was commenced. Following over 9 months of treatment, there was no significant reduction in the size of her cervical lymph nodes, and she experienced recurrent low-grade fever. One sample from the fourth lymph node biopsy tested negative for metagenomic next-generation sequencing, and another sample tested positive in the BACTEC MGIT960 liquid culture system, identifying the strains as Mycobacterium chimaera. Anti-non-tuberculous mycobacteria therapy was initiated, and the patient achieved symptom improvement. In conclusion, non-tuberculous mycobacteria lymphoid infection is easily misdiagnosed as long-term etiologic negativity.
Keywords: Non-tuberculous mycobacteria, Mycobacterium avium Complex, Mycobacteria chimaera, Lymphadenitis, diagnosis, case report
Received: 18 Feb 2024; Accepted: 29 Aug 2024.
Copyright: © 2024 Sun, Zhang, Lu, Chen and Pan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xinling Pan, Department of Biomedical Sciences Laboratory, Dongyang Hospital of Wenzhou Medical University, Dongyang, China
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