Disseminated Mycobacterium avium infection in a young woman with sickle cell disease and iatrogenic iron overload

Pouria Hosseini, Yogamaya Mantha, Shannon J Koh, Gebre K Tseggay, Jyothi K Baby, Rahul Gill, Mark Feldman


A 29-year-old woman with known sickle cell disease (SCD) and iatrogenic iron overload presented to the emergency department with a recurrent pain crisis and fever. Blood cultures obtained at a recent prior admission for the same complaints grew M avium. Bone marrow biopsy revealed non-caseating granulomas, but stains for mycobacteria and fungi were negative. Disseminated non-tuberculous mycobacterial infections (NTMIs) occur almost exclusively in immunosuppressed patients. SCD is not considered a risk factor for the development of disseminated NTMIs, making diagnosis challenging in this population. However, a number of case reports describing disseminated NTMIs in patients with SCD have been published. This case adds to the current literature, suggesting SCD with iatrogenic iron overload is a possible risk factor for disseminated NTMIs. Potential mechanisms for this increased risk include 1) functional asplenia, 2) iatrogenic iron overload, 3) chronic indwelling central venous catheters, and 4) hydroxyurea use. Further investigation is required to describe the strength and mechanism of the relationship between SCD and disseminated NTMIs.

Full Text:


DOI: https://doi.org/10.5430/crim.v8n2p5


  • There are currently no refbacks.

Case Reports in Internal Medicine

ISSN 2332-7243(Print)  ISSN 2332-7251(Online)

Copyright © Sciedu Press

To make sure that you can receive messages from us, please add the ‘sciedupress.com’ domains to your e-mail 'safe list'. If you do not receive e-mail in your 'inbox', please check your 'spam' or 'junk' folder.