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Granulomatous lymphadenitis due to Mycobacterium scrofulaceum in patient with HIV
Granulomatous lymphadenitis due to Mycobacterium scrofulaceum in patient with HIV
Carlos E. Valderrama-Xilotl 1 
, Alistair Jiménez-Triana 1 , Iñigo Díaz-Moreno 1 , Diego Ontañón-Zurita 2
1 Departamento de Medicina Interna, Centro Médico ABC, Ciudad de México, México; 2 Departamento de Infectología, Centro Médico ABC, Ciudad de México, México
*Correspondence: Carlos E. Valderrama-Xilotl. Email: carlosvalderrama03@gmail.com
Abstract
Disseminated Mycobacterium scrofulaceum infection is a rare condition, occurring primarily in immunocompromised adults. We report the case of a 35-year-old woman with newly diagnosed human immunodeficiency virus infection who presented with fever, abdominal pain, and unintentional weight loss. Imaging revealed widespread lymphadenopathy, and positron emission tomography showed hypermetabolic activity. Lymph node biopsy demonstrated granulomatous inflammation with acid-fast bacilli and polymerase chain reaction confirmed M. scrofulaceum. Targeted antimicrobial therapy was initiated, and antiretroviral treatment was adjusted due to drug interactions. Clinical response was favorable, with complete radiological resolution at 8 weeks. This case highlights the importance of considering nontuberculous mycobacteria in the differential diagnosis of persistent lymphadenopathy in severely immunocompromised patients, and underscores the utility of molecular methods for early identification.
Keywords: Mycobacterium scrofulaceum. Nontuberculous mycobacteria. HIV. Lymphadenitis.
