Disseminated Mycobacterium: A Rare Case of Chronic Severe Diarrhea in a Patient with HIV
Anirudh R. Damughatla, Pragna Koleti, Mohamad Khaled Almujarkesh, Martina Tripcovici, Sarvani Surapaneni, Andrew Kumar, William Smith, Lea M Monday, Anand Ravi
Diarrhea is a common problem in people living with HIV (PLWH). Both infectious and non- infectious
causes are possible, thus making the diagnosis a challenge. Non-infectious causes commonly include
HIV enteropathy, antiretroviral therapy (ART), or other medications. Infectious causes vary depending
on the degree of viral control and whether there is profound immunosuppression due to acquired
immunodeficiency syndrome (AIDS). Infectious causes include viral, bacterial, mycobacterial, and
protozoal pathogens. Due to the broad differential, diagnosis can be delayed or missed leading to
increased morbidity and mortality. While mycobacterium avium complex (MAC) is a known cause of
infectious diarrhea in AIDS patients, other non-tuberculous mycobacteria (NTM) are less common.
Here we present a case of extrapulmonary disseminated non-MAC NTM infection in an HIV patient
who presented with chronic severe diarrhea that was initially misdiagnosed as CMV colitis. Our case
highlights that concomitant infections which occur in HIV can mislead the diagnosis and delay the
treatment.
