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1/7. A meningioma-mimicking tumor caused by mycobacterium avium complex in an immunocompromised patient.

    Intracranial tuberculomas manifesting radiologically as typical dural-based "meningiomas" have been reported, most frequently in immunosuppressed patients. Their incidence is high in developing countries; they are only sporadically observed in Western europe and north america, usually in patients with acquired immunodeficiency syndrome (AIDS). According to published reports, intracranial tuberculomas are always due to infection by mycobacterium tuberculosis. We report a case of a 50-year-old woman with systemic lupus erythematosus (SLE) who presented with a dural based, meningioma-like mass in the right frontal region, resulting from a localized infection by mycobacterium avium complex. Histologically, the mass resembled a meningioma in being composed of spindly cells arranged in a fascicular pattern. Immunohistochemical stains showed this tumor to consist of a large aggregate of AFB-laden histiocytes without caseating necrosis or multinucleated giant cells.
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keywords = avium
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2/7. mycobacterium avium complex-associated hemophagocytic syndrome in systemic lupus erythematosus patient: report of one case.

    Hemophagocytic syndrome (HPS) in systemic lupus erythematosus(SLE) patients has not commonly been reported. In this case study, we report the first case of mycobacterium avium complex (MAC)-associated hemophagocytic syndrome in a patient with systemic lupus erythematosus (SLE). This SLE patient, a 15-year-old girl, had been on a high dose of prednisolone (> 0.5mg/kg/day) for more than 3 years. She presented with a spiking fever, hepatosplenomegaly, pancytopenia, hyperferritinemia and adult respiratory distress syndrome. bone marrow examination revealed hemophagocytosis as well as non-caseating granulomatosis. There was no indication of SLE fare-up. She responded poorly to initial treatment with methyl-prednisolone, intravenous immumoglobulin, etoposide, and drugs for mycobacterium tuberculosis including rifampin, ethambutol, isoniazid and pyramide. However, gastric lavage culture revealed MAC. Following treatment with clarithromycin, ciprofloxacin and amikacin, her condition gradually improved and she was discharged 3 months after admission. In SLE patients with pancytopenia and hyperferritinemia, MAC-associated HPS should be considered in the differential diagnosis.
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keywords = avium
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3/7. Scintigraphic findings of mycobacterium avium complex tenosynovitis of the index finger in a patient with systemic lupus erythematosus.

    The presented case is a 36-year-old woman with a history of systemic lupus erythematosus for 10 years. She had progressively painful swelling of the right index finger that later proved to be a rare case of tenosynovitis caused by mycobacterium avium complex. Serial images of 3-phase bone scans, gallium scan, and magnetic resonance imaging demonstrate the area of involvement.
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keywords = avium
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4/7. A patient with a mycobacterium avium complex infection complicated by systemic lupus erythematosus.

    A 41-year-old woman was admitted to our hospital because of fever and polyarthralgia. A diagnosis of systemic lupus erythematosus (SLE) was made based on the findings of polyarthritis, leukocytopenia, lymphocytopenia, proteinuria, and positive reactions for antinuclear antibody (ANA) and anti-double strand (ds)dna antibody. She had also been suffering from a pulmonary mycobacterium avium complex (MAC) infection with such symptoms as cough and sputum for the past 3 years. Antimicrobial drugs for MAC infection were administered first, and later she was given cyclophosphamide pulse therapy, consisting of methylprednisolone (8 mg/day) and mizoribine (100 mg/day). Owing to these therapeutic regimens, SLE was successfully treated without an exacerbation of the MAC infection. The risk factors for MAC infection and SLE are also discussed.
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keywords = avium
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5/7. Septic arthritis associated with mycobacterium avium: a case report and literature review.

    A 58 year old man, with systemic lupus erythematosus, developed septic arthritis due to an atypical mycobacterium, M. avium. The patient's course, as well as 46 cases reviewed from the literature, illustrates the insidious nature of atypical mycobacterial infections. Septic arthritis or peri-arthritis was generally not suspected at initial evaluation, leading or at least 40% of patients receiving intra-articular steroids for non-specific reasons. A diagnosis was eventually obtained in 85% of cases by surgical biopsy and culture. In only15% was a diagnosis made by culture of synovial or bursal fluid. The relative in vitro resistance of "atypicals" to antituberculous drugs and the frequent necessity for surgery to make a diagnosis, led to surgery consituting partial or total therapy in 89% of cases. Whether patients were treated with surgery alone, surgery plus antituberculous drugs, or antituberculous drugs alone, clinical improvement generally occured. Because most patients had limited follow-up and because atypical mycobacterial infections often relapse, none of the cases reviewed should be considered "cures", be but rather instances of clinically inactive disease.
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ranking = 23.012577369203
keywords = mycobacterium avium, mycobacterium, avium
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6/7. mycobacterium avium complex infection limited to the skin in a patient with systemic lupus erythematosus.

    We describe a case of Mycobacterium avium infection of the skin in a 51-year-old woman with systemic lupus erythematosus. Two lesions were treated with a combination of oral tetracycline or minocycline and hyperthermia using a portable warmer. One subsequently healed, leaving an atrophic scar, but the other lesion persisted, and was eventually excised.
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keywords = avium
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7/7. Spinal osteomyelitis due to Mycobacterium avium-intracellulare in an elderly man with steroid-induced osteoporosis.

    Disseminated mycobacterial infections are becoming widely appreciated among immunosuppressed and debilitated persons. Specific microbiologic diagnosis may take several weeks, requiring empiric therapy in the interim. A case of an elderly man undergoing steroid treatment who developed spinal osteomyelitis initially thought to be caused by mycobacterium tuberculosis is described. He was eventually shown to have infection due to M. avium-intracellulare, which requires a different therapeutic approach. The importance of considering atypical mycobacteria in systemic infections and the value of aggressive antimicrobial therapy in conjunction with a comprehensive rehabilitation program during hospitalization are emphasized in order to provide optimal management and prevent further disability.
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keywords = avium
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