Acquired immunodeficiency syndrome-like illness associated with systemic Mycoplasma fermentans infection in a human immunodeficiency virus-negative homosexual man

William R. Macon, Shyh Ching Lo, Bernard J. Poiesz, David C. Montefiori, Marilyn S. Dawson, Thomas E. Mason, Paul R. Michael, Alan G. Cohen, Caria M. Davis, John B. Cousar, Charles W. Stratton

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

A 35-year-old homosexual man developed a composite nodal Kaposi's sarcoma and peripheral T-cell lymphoma that were associated with a peripheral blood CD4-positive lymphocyle count of only 43/mm3. The patient subsequently developed Pneumocystis carinii pneumonitis and eventually died due to disseminated Cryptococcus neoformans. Numerous premortem tests for the presence of human immunodeficiency virus (HIV) types 1 and 2 were negative by the enzyme-linked immunosorbent assay, Western blot, viral isolation, and polymerase chain reaction techniques. Postmortem evaluations for HIV-1, HIV-2, human T-cell lymphotropic virus (HTLV)-I, and HTLV-II also were negative by polymerase chain reaction, immunofluorescence assays, and viral isolation. A systemic infection by Mycoplasma fermentans, however, was documented by immunohistochemistry and polymerase chain reaction in premortem and post-mortem tissues. This recently recognized human pathogen has produced systemic infections in patients with the acquired immunodeficiency syndrome (AIDS) and in previously healthy non-AIDS patients who characteristically have a fulminant flu-like illness. Additionally, M fermentans has enhanced the cytopathic effect of HIV in in vitro studies and has produced fatal wasting illnesses with terminal lymphopenia in inoculated adult silvered leaf monkeys. This report is the first description of an association between M fermentans infection and an AIDS-like illness in an HIV-negative individual. The etiology of the severe immunosuppression in this patient and the associated role of M fermentans remain to be determined by further investigations.

Original languageEnglish (US)
Pages (from-to)554-558
Number of pages5
JournalHuman Pathology
Volume24
Issue number5
DOIs
StatePublished - May 1993

Keywords

  • Kaposi's sarcoma
  • Mycoplasma fermentans
  • T-cell lymphoma
  • acquired immunodeficiency syndrome
  • idiopathic CD4-positive T lymphocytopenia

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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    Macon, W. R., Lo, S. C., Poiesz, B. J., Montefiori, D. C., Dawson, M. S., Mason, T. E., Michael, P. R., Cohen, A. G., Davis, C. M., Cousar, J. B., & Stratton, C. W. (1993). Acquired immunodeficiency syndrome-like illness associated with systemic Mycoplasma fermentans infection in a human immunodeficiency virus-negative homosexual man. Human Pathology, 24(5), 554-558. https://doi.org/10.1016/0046-8177(93)90169-H