Disseminated MAI in an HIV Patient-An Unusual Presentation
Joshni Simon,
Joella Lambert,
Jose Mosco-Guzman,
Kaitlyn Dittmer,
Alison Stern-Harbutte,
Weston Connelly
Affiliations
Joshni Simon
Graduate Medical Education, USF Morsani College of Medicine, HCA Healthcare, Largo Medical Center, 201 14th St SW, Largo, FL 33770, USA
Joella Lambert
Graduate Medical Education, USF Morsani College of Medicine, HCA Healthcare, Largo Medical Center, 201 14th St SW, Largo, FL 33770, USA
Jose Mosco-Guzman
Graduate Medical Education, USF Morsani College of Medicine, HCA Healthcare, Largo Medical Center, 201 14th St SW, Largo, FL 33770, USA
Kaitlyn Dittmer
Medical Education Department, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Tampa Bay Regional Campus, 3400 Gulf to Bay Blvd, Clearwater, FL 33759, USA
Alison Stern-Harbutte
Medical Education Department, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Tampa Bay Regional Campus, 3400 Gulf to Bay Blvd, Clearwater, FL 33759, USA
Weston Connelly
Graduate Medical Education, USF Morsani College of Medicine, HCA Healthcare, Largo Medical Center, 201 14th St SW, Largo, FL 33770, USA
Patients with Human Immunodeficiency Virus (HIV), and especially Acquired Immunodeficiency Syndrome (AIDS), can present in a multitude of ways with a variety of possible pathologies. This can prove to be a challenge to a clinician. The patient, in this case, was found to have disseminated Mycobacterium-avium-intracellulare (MAI), despite compliance with antiretroviral therapy (ART), who presented with right upper quadrant pain, isolated elevated alkaline phosphatase, and sepsis. Imaging revealed multiple splenic lesions, bilateral psoas abscesses, abdominal lymphadenopathy, and a large right pleural effusion with a mediastinal shift to the left. Psoas abscesses were drained and the cultures grew acid-fast bacilli. The patient was treated with azithromycin, ethambutol and rifabutin. Classically, MAI infections of patients compliant with ART therapy present with localized disease. This case offers a different presentation of MAI despite compliance with ART therapy.
