Mycobacterium xenopi infection masquerading as pulmonary tuberculosis in two patients infected with the human immunodeficiency virus

• Published in: Clinical infectious diseases Vol. 20; no. 5; p. 1399
• Main Authors: Jacoby, H M, Jiva, T M, Kaminski, D A, Weymouth, L A, Portmore, A C
• Format: Journal Article
• Language: English
• Published: United States 01.05.1995
• Subjects: Adult; AIDS-Related Opportunistic Infections - diagnosis; Humans; Male; Mycobacterium Infections, Nontuberculous - diagnosis; Nontuberculous Mycobacteria - isolation & purification; Tuberculosis, Pulmonary - diagnosis
• ISSN: 1058-4838
• DOI: 10.1093/clinids/20.5.1399

Mycobacterium xenopi infections have rarely been reported among patients infected with the human immunodeficiency virus (HIV). We recently treated two HIV-infected men, neither of whom had a history of pulmonary disease or AIDS-defining conditions, and who had M. xenopi lung infections. Both patients presented with night sweats, cough, and pleuritic chest pain. Chest radiographs showed an upper-lobe nodule in the first patient and a perihilar cavitary infiltrate in the second patient. Both patients were initially believed to have pulmonary tuberculosis and were treated accordingly; however, only M. xenopi grew on cultures of multiple respiratory specimens. This diagnosis was confirmed by cultures of biopsied lung tissue from the first patient and of fluid from a peritracheal abscess in the second patient. Both patients' clinical conditions improved after multidrug therapy (isoniazid, rifampin, pyrazinamide, ethambutol, and ciprofloxacin in the first case; isoniazid, rifampin, and pyrazinamide in the second case). The second patient's condition improved despite in vitro resistance of his isolate to isoniazid and rifampin.