Infection and Drug Resistance (Dec 2023)

Mycobacterium colombiense Pneumonia in HIV-Infected Patients: Three Case Reports and a Literature Review

  • Guo Y,
  • Li X,
  • Xiao Q,
  • Yang J,
  • Tao R,
  • Xu L,
  • Zhu B

Journal volume & issue
Vol. Volume 16
pp. 7767 – 7773

Abstract

Read online

Yongzheng Guo,1 Xiaofeng Li,2 Qianggu Xiao,3 Jie Yang,4 Ran Tao,1 Lijun Xu,1 Biao Zhu1 1The Department of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China; 2The Department of Infectious Diseases, Huzhou Central Hospital, Huzhou, Zhejiang, People’s Republic of China; 3The Department of Infectious Diseases, Xiaoshan First People’s Hospital, Hangzhou, Zhejiang, People’s Republic of China; 4The Department of Infectious Diseases, Lishui Municipal Central Hospital, Lishui, Zhejiang, People’s Republic of ChinaCorrespondence: Biao Zhu, Email [email protected]: Mycobacterium colombiense pneumonia in HIV-infected patients is relatively unusual but is associated with a high mortality rate, as well as high rates of misdiagnosis and delayed diagnosis. Clinical metagenome next-generation sequencing (mNGS) may have potential for its accurate and timely diagnosis.Case Presentation: We retrospectively reviewed the medical records of three HIV-infected patients who presented with M. colombiense pneumonia in Zhejiang Province between January 2019 and December 2020. No specific clinical presentations or radiological manifestations were found in any of the patients. The detection of M. colombiense is 28– 55 days earlier using mNGS on bronchoalveolar lavage fluid (BALF) compared to traditional culture methods. A combined treatment of rifabutin, clarithromycin, or azithromycin, and ethambutol did not provide timely relief of symptoms in these three patients. In the early stage of treatment, moxifloxacin and linezolid were used for several weeks. The average course of treatment for all three patients was close to 17 months.Conclusion: We recommend early BALF mNGS for fast and accurate diagnosis of M. colombiense pneumonia in HIV-infected patients with low CD4 counts and long duration of symptoms. Further, moxifloxacin and linezolid may be beneficial in the early stage of treatment.Keywords: metagenomic next-generation sequencing, nontuberculous mycobacteria, Mycobacterium colombiense, pneumonitis, HIV, AIDS

Keywords