Misindentification of Mycobacterium kumamotonense as M. tuberculosis

摘要

To the Editor: Because of slow growth of mycobacteria, use of rapid tests to identify them is strongly rec-ommended; rapid tests are widely used as an advanced diagnostic tool in clinical laboratories (1,2). These tests are particularly useful for diagnos-ing extrapulmonary mycobacterioses and identifying unusual mycobacteria as etiologic agents (3). Commercial probes are frequently used for rapid and specifi c identifi cation of myco-bacteria, especially Mycobacterium tuberculosis complex. However, cross-reactivity of DNA probes between mycobacterial species could result in incorrect diagnosis and treatment of patients (4,5). Misidentifi cation could be a problem if a newly described spe-cies, such as M. kumamotonense (6), were an etiologic agent of a disease.In July 2006, we obtained a fi ne-needle, puncture aspiration biopsy specimen from a cervical lymph node of a 30-year-old man at Doce de Oc-tubre Hospital (Madrid, Spain). The patient was a recent immigrant from Paraguay and was HIV positive (C2 stage of infection). A biopsy speci-men from a cervical lymph node showed necrotizing granulomatous lymphadenopathy. A computed to-mographic scan showed cervico-tho-raco-abdominal, multiple cervical,supraclavicular, axillar, paratracheal, and mediastinal lymphadenopathies. The patient had a CD4 cell count of 219 cells/mm3and an HIV viral load of 197,181 copies/mL