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Disseminated Mycobacterium avium Complex Infection in a Patient Treated With Immunosuppressants

Ito, Yuki Watanabe, Daisuke Ikeda, Sayaka Okamoto, Norihiro Miyazaki, Haruka Tokunaga, Eri Ku, Yuna Ooi, Makoto Hoshi, Namiko Kodama, Yuzo 神戸大学

2023.04

概要

Mycobacterium avium complex (MAC) is an important cause of opportunistic infections in immunosuppressed hosts, such as patients with HIV infection and solid organ transplant recipients. MAC disease usually presents in 4 distinct clinical categories: chronic pulmonary disease, disseminated disease, skin/soft-tissue infection, and superficial lymphadenitis. However, clinical reports on gastrointestinal (GI) MAC disease are rare, especially in patients without HIV infection or a history of organ transplantation. We describe a case of non-HIV-associated GI MAC disease in a patient with long-term mycophenolate mofetil use. In this case, MAC organisms in the GI tract and ascites were observed. Endoscopy revealed a unique colonic image with large, deep epithelial denudations. This suggests that apart from patients with HIV infection or transplant recipients, those treated with immunosuppressants can have disseminated MAC. Therefore, internal physicians need to monitor patients undergoing mycophenolate mofetil immunosuppressant therapy.

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Copyright: ª 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of

The American College of Gastroenterology. This is an open access article distributed

under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work

is properly cited.

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