Surprising findings in the bone marrow: what lies behind it?

Czech version

Authors: T. Horňák ^1,*; N. Holtánová ^1,*; L. Křen ²; J. Skřičková ³; A. Hrazdirová ³; J. Mayer ^1,4; D. Žáčková ¹
Authors‘ workplace: Oba autoři se na vzniku manuskriptu podíleli rovným dílem. ^*; Interní, hematologická a onkologická klinika, FN Brno a LF MU ¹; Ústav patologie, FN Brno ²; Klinika nemocí plicních a TBC, FN Brno a LF MU ³; CEITEC Masarykova Univerzita, Brno ⁴
Published in: Transfuze Hematol. dnes,26, 2020, No. 2, p. 139-142.
Category: Case Reports

Overview

This case study describes the complex diagnostic and therapeutic process in an immunocompetent patient suffering from a disseminated nontuberculous mycobacteria infection caused by Mycobacterium avium complex. During the infection, the patient suffered from pancytopenia, liver damage and acute renal failure. Necrotizing granulomatosis was found in bone marrow and splenic tissue with no signs of infection macroscopically or using imaging methods. Diagnosis was eventually determined by microbial cultivation of splenic tissue. The patient was then prescribed targeted antituberculotic treatment, which led to clinical and laboratory improvement.

Keywords:

infection – pancytopenia – atypical mycobacteria – granulomatous inflammation

Sources

1. Jeon D. Infection source and epidemiology of nontuberculous mycobacterial lung disease. Tuberc Respir Dis (Seoul). 2019;2:94–101.

2. Lande L, George J, Plush T. Mycobacterium avium complex pulmonary disease: new epidemiology and management concepts. Curr Opin Infect Dis. 2018;2:199–207.

3. Wickramasinghe SN, McCullough J. Blood and Bone Marrow PATHOLOGY. Edinburgh, Churchill Livingstone, 2002; 110.

4. Tortoli E. Clinical manifestations of nontuberculous mycobacteria infections. Clin Microbiol Infect. 2009;15:906–910.

5. Beswick J, Shin E, Michelis FV, et al. Incidence and risk factors for nontuberculous mycobacterial infection after allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2018;2:366–372.

6. Sato M, Hiyama T, Kaito K, et al. Usefulness of F-18 FDG PET/CT in the assessment of disseminated Mycobacterium avium complex infection. Ann Nucl Med. 2009;8:757–762.

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Article was published in

Transfusion and Haematology Today

2020 Issue 2