Case Report

Localized Mycobacterium avium Complex Infection of Vertebral and Paravertebral Structures in an HIV Patient on Highly Active Antiretroviral Therapy

Authors: Vicente Corrales-Medina, MD, Stephen Symes, MD, Martin Valdivia-Arenas, MD, Catherine Boulanger, MD


Before the introduction of highly active antiretroviral therapy (HAART)Mycobacterium avium complex (MAC) disease was the most common bacterial infection in patients with acquired immune deficiency syndrome (AIDS) in developed countries.1 Effective antiviral therapy against HIV has allowed for control of viral replication, improvement in immune function, and a significant decrease in opportunistic infections (OIs).2 However, atypical presentations of these infections have been increasingly described in patients a few weeks after the initiation of HAART. This clinical worsening despite decrease in HIV viral load and increase in CD4+ lymphocyte cell count is called immune reconstitution syndrome (IRS).3 We report a case of localized vertebral and paravertebral MAC infection in an HIV-infected patient with high CD4+ lymphocyte counts, more than one year after starting antiretroviral therapy.

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