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Multiple Infectious Intracranial Lesions of Mycobacterium genavense in an Immunocompromised Patient Haruto Uchino 1 , Shunsuke Terasaka 1 , Shigeru Yamaguchi 1 , Hiroyuki Kobayashi 1 , Kagari Kawai 1 , Kanako Kubota 2 , Shinji Ooe 3 , Kiyohiro Houkin 1 1Department of Neurosurgery,Graduate School of Medicine,Hokkaido University 2Department of Surgical Pathology,Hokkaido University Hospital 3Department of General Medicine,Hokkaido Shakaihoken Hospital Keyword: brain biopsy , central nervous system , immunodeficiency , Mycobacterium genavense , nontuberculous mycobacterium pp.79-83
Published Date 2011/1/1
DOI https://doi.org/10.11477/mf.1416100820
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Abstract

 Nontuberculous mycobacteria rarely infect the central nervous system. Recently, Mycobacterium genavense, nontuberculous mycobacterium (NTM), has been identified as a significant pathogen in patients. In this report, we describe multiple intracranial lesions caused by M. genavense in an immunocompromised host. A 50-year-old man presented with dysarthria, aphasia, and right hemiparesis. He had a primary immunodeficiency and a M. genavense infection in the thoracic and abdominal lymph nodes. Magnetic resonance imaging revealed multiple intracranial masses in the subcortical regions with extensive perifocal edema. Laboratory investigations and cultures of cerebrospinal fluid provided no evidence of disseminated infection. We obtained a biopsy sample via a small craniotomy using neuronavigation, and NTM infection was confirmed on analysis of the specimen. He was treated with antimycobacterial agents, and the clinical symptoms and radiological findings improved. Although a surgical procedure bears the potential risk of infection, especially in an immunocompromised patient, a brain biopsy was necessary for definitive diagnosis in this case and it aided in the administration of appropriate treatment.

(Received: June 11,2010,Accepted: August 9,2010)


Copyright © 2011, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院

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