Mycobacterium bovis infections in HIV patients: Report of four cases in Spain

Abstract Although tuberculosis due to Mycobacterium tuberculosis is common among patients with the acquired immunodeficiency syndrome (AIDS), infection caused by Mycobacterium bovis has rarely been described. Tuberculosis due to multidrug-resistant M. bovis is extremely uncommon. Four cases of HIV-related tuberculosis due to M. bovis are described. Two patients presented had pulmonary disease, the third had a disseminated infection with M. bovis isolated from blood, bronchoalveolar lavage samples, and sputum, and a fourth patient had a limited lymphnode involvement. Multidrug-resistant M. bovis was found in three of our patients. The course was fatal in all of the cases, as with previous multidrug-resistant M. bovis strains. Although the M. bovis infection in the fourth patient was not multidrug-resistant, the patient did not respond to first-line antituberculous drugs. In summary, M. bovis should be considered a pathogen to be suspected in AIDS patients, especially in endemic regions, where the possibility of transmission of multiresistant strains should be seriously considered.