Document 0697
 DOCN  M94A0697
 TI    An unusual mycobacterial infection with osteomyelitis and skin lesions
       in an HIV patient.
 DT    9412
 AU    Street AC; Fairfield Hospital, Vic.
 SO    Annu Conf Australas Soc HIV Med. 1993 Oct 28-30;5:33 (abstract no. FC4).
       Unique Identifier : AIDSLINE ASHM5/94348958
 AB    Atypical mycobacterial infections other than those due to Mycobacterium
       avium complex are very uncommon in HIV patients. This report describes a
       case of Mycobacterium haemophilum (MH) infection with skin, bone and
       bloodstream involvement. A 42 year old HIV positive male with no prior
       AIDS-defining illness and a CD4 count of 0.01 x 10(9)/l presented in May
       1991 with a tender swelling over the right olecranon process. Fluid
       aspirated from the swelling was positive by smear for acid fast bacilli,
       and an X-ray suggested underlying osteomyelitis. The organism isolated
       from the aspirate and also from blood was identified as Mycobacterium
       haemophilum. Over the past 2 years, MH infection has persisted with
       slowly progressive cutaneous disease, chronic osteomyelitis and
       intermittent mycobacteraemia. He is currently being treated with
       ethambutol, rifabutin, clofazamine, clarithromycin and doxycycline. MH
       infection is rare, this case being the sole example among more than 700
       AIDS patients treated at Fairfield Hospital. MH should be suspected in
       patients with osteomyelitis or chronic nodular or ulcerative skin
       lesions. Response to antimycobacterial therapy has been difficult to
       assess in this and other reported patients and the optimal treatment
       regimen is unknown. Despite not being able to eradicate the organism,
       this patient has not been systemically unwell and has lived for over 2
       years with this slowly progressive infection.
 DE    Adult  AIDS-Related Opportunistic Infections/*DIAGNOSIS/MICROBIOLOGY
       Bacteremia/DIAGNOSIS/MICROBIOLOGY  Case Report  Human  Male
       Mycobacterium Infections, Atypical/*DIAGNOSIS/MICROBIOLOGY
       Mycobacterium, Atypical/ISOLATION & PURIF
       Osteomyelitis/*DIAGNOSIS/MICROBIOLOGY  Tuberculosis,
       Cutaneous/*DIAGNOSIS/MICROBIOLOGY  Tuberculosis,
       Osteoarticular/*DIAGNOSIS/MICROBIOLOGY  MEETING ABSTRACT

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