Disseminated Mycobacterium abscessus infection with idiopathic CD4+ T-lymphocytopenia: a case report and review of the literature

J Med Case Rep. 2024 Dec 31;18(1):645. doi: 10.1186/s13256-024-05009-w.

Abstract

Background: Idiopathic CD4+ T lymphocytopenia is a rare immune dysfunction disease that is usually found after opportunistic infections. Mycobacterium abscessus is a rapidly growing mycobacterium that can cause pulmonary infections, lymphadenitis, skin and soft tissue infections, disseminated infections, among others, as a conditional pathogenic bacterium.

Case presentation: We present the case of a 43-year-old Chinese woman who developed disseminated Mycobacterium abscessus infection due to idiopathic CD4+ T lymphocytopenia. The patient exhibited symptoms including skin infections, lymphadenitis, and bacteremia. A tailored multidrug therapy was initiated, guided by drug susceptibility testing. Within a month of treatment, the patient's fever resolved, and she exhibited a significant recovery and was discharged.

Conclusions: Cases of clinical idiopathic CD4+ T lymphocytopenia with Mycobacterium abscessus infection are not common. Clinicians should be vigilant and accurately identify Mycobacterium abscessus as an opportunistic pathogen when dealing with immunocompromised patients, in particular with idiopathic CD4+ T lymphocytopenia.

Keywords: Mycobacterium abscessus; Antimicrobial susceptibility test; Bloodstream infection; Clinical characteristics; Idiopathic CD4+ T-lymphocytopenia (ICL).

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Anti-Bacterial Agents* / therapeutic use
  • Female
  • Humans
  • Immunocompromised Host
  • Mycobacterium Infections, Nontuberculous* / diagnosis
  • Mycobacterium Infections, Nontuberculous* / drug therapy
  • Mycobacterium Infections, Nontuberculous* / microbiology
  • Mycobacterium abscessus* / isolation & purification
  • Opportunistic Infections / diagnosis
  • Opportunistic Infections / drug therapy
  • Opportunistic Infections / microbiology
  • T-Lymphocytopenia, Idiopathic CD4-Positive* / complications
  • T-Lymphocytopenia, Idiopathic CD4-Positive* / diagnosis
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents