Document 0157
 DOCN  M9650157
 TI    Cervical lymphadenitis caused by a fastidious mycobacterium closely
       related to Mycobacterium genavense in an apparently immunocompetent
       woman: diagnosis by culture-free microbiological methods.
 DT    9605
 AU    Bosquee L; Bottger EC; De Beenhouwer H; Fonteyne PA; Hirschel B; Larsson
       L; Meyers WM; Palomino JC; Realini L; Rigouts L; et al; Hopital de
       Verviers, Verviers, Antwerp, Belgium.
 SO    J Clin Microbiol. 1995 Oct;33(10):2670-4. Unique Identifier : AIDSLINE
       MED/96087207
 AB    Fastidious mycobacteria usually infect immunocompromised hosts (human
       immunodeficiency virus-infected or otherwise immunosuppressed patients).
       We here describe severe lymphadenitis, caused by a fastidious
       mycobacterium closely related to Mycobacterium genavense, in an
       apparently immunocompetent woman, whose brother had died from an
       unidentified mycobacterial infection in 1969. A variety of techniques,
       including inoculation of nude mice, histopathology, electron microscopy,
       lipid analysis, ATP measurements, and molecular biology, were used to
       characterize this mycobacterium. All attempts to culture the etiological
       agent on many different media failed. The organism multiplied only in
       congenitally athymic nude mice. Although phenotypically similar to M.
       genavense, the mycobacterium differs from M. genavense by three
       nucleotides of the 16S rRNA gene sequence. Various antimycobacterial
       drugs were administered, including gamma interferon, but multiple
       relapses occurred. Finally, therapy with a combined regimen of
       clarithromycin, clofazimine, rifabutin, and ethambutol was curative. To
       our knowledge, this is the first report of lymphadenitis in an
       apparently immunocompetent patient, caused by a noncultivable
       Mycobacterium sp. closely related to M. genavense. This study emphasizes
       the importance of employing a variety of diagnostic approaches such as
       the inoculation of laboratory animals, histopathology, electron
       microscopy, lipid analysis, ATP measurements, and molecular biology to
       characterize novel microorganisms that cannot be cultured in vitro.
 DE    Adenosine Triphosphate/ANALYSIS  Animal  Biopsy  Case Report
       Comparative Study  DNA, Ribosomal  Female  Human  Immunocompetence
       Lipids/ANALYSIS  Lymph Nodes/*MICROBIOLOGY/PATHOLOGY
       Lymphadenitis/*MICROBIOLOGY/PATHOLOGY  Mice  Mice, Inbred BALB C  Mice,
       Nude  Microbial Sensitivity Tests  Middle Age  Monocytes/IMMUNOLOGY
       Mycobacterium/*CLASSIFICATION/GROWTH & DEVELOPMENT/GENETICS
       Mycobacterium Infections/*DIAGNOSIS/PATHOLOGY
       Neck/MICROBIOLOGY/PATHOLOGY  RNA, Ribosomal, 16S/GENETICS  Support,
       Non-U.S. Gov't  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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