Abstract
A 55-year-old woman with systemic lupus erythematosus was admitted with fever of unknown origin. She had been on an immunosuppressive regimen for the past 8 years including steroids and Azathioprine. Laboratory parameters revealed a markedly elevated C-reactive protein of 189 mg/l, antinuclear antibodies of 1:2,560, a hemoglobin level of 9.0 g/dl, and a severe lymphopenia (total lymphocytes 49.4/μl, CD4+ cells 2/μl, CD8+ cells 7/μl). Neither blood culture samples nor computed tomography and magnetic resonance imaging of the chest and abdomen nor a trans-esophageal echocardiography revealed positive results. A bone marrow biopsy did not show signs of hematologic disease, but revealed a small granuloma rife with acid-fast bacilli, which were later confirmed to be Mycobacterium genavense by gene sequencing. To our knowledge, this is the first case involving M. genavense infection in a patient with systemic lupus erythematosus. In contrast to other reports regarding disseminated M. genavense infection, the patient is still alive and well.
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Lorenzen, J., Meyer-Olson, D., Haubitz, M. et al. Infection with Mycobacterium genavense in a patient with systemic lupus erythematosus. Clin Rheumatol 28 (Suppl 1), 39–41 (2009). https://doi.org/10.1007/s10067-009-1120-4
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DOI: https://doi.org/10.1007/s10067-009-1120-4