A young female patient with anorexia nervosa complicated by Mycobacterium szulgai pulmonary infection

Authors

  • Mari Hotta,

    Corresponding author
    1. Health Services Center, National Graduate Institute For Policy Studies, Tokyo, Japan
    2. Department of Medicine, Institute of Clinical Endocrinology, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
    • Health Services Center, National Graduate Institute For Policy Studies, 2-2 Wakamatsu-cho, Shinjuku-ku, Tokyo 162-8677 Japan
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  • Yuichiro Minami,

    1. Department of Cardiology, The Heart Institute, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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  • Ichiro Itoda,

    1. Department of Infectious Diseases, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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  • Kozo Yoshimori,

    1. Department of Respiratory Organs, Fukujuji Hospital, Anti-Tuberculosis Association, Tokyo, Japan
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  • Kazue Takano

    1. Department of Medicine, Institute of Clinical Endocrinology, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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Abstract

Objective

Pulmonary infection with a rare atypical mycobacterium, Mycobacterium szulgai, was discovered during the treatment of anorexia nervosa in a 21-year-old Japanese woman without preexisting pulmonary disease. She had a long history of low body weight below 35kg.

Methods

On admission, she was examined. She weighed 23kg and presented with hypoproteinemia, decreased levels of rapid turnover proteins, liver dysfunction, and decreased serum level of insulin-like growth factor-I.

Results

Although she had had neither clinical symptom specific for mycobacterium pulmonary infection nor inflammatory data, a chest roentgenogram showed an infiltrative shadow with cavity formation in the right upper lung field. Isolated bacteria from sputum was acid-fast bacilli and identified as M. szulgai using the DNA-DNA hybridization method.

Discussion

In anorexia nervosa patients with a long history of severe malnutrition, special attention must be paid to the possibility of opportunistic infections, even in the absence of symptoms or inflammatory data. © 2003 by Wiley Periodicals, Inc. Int J Eat Disord 35: 115–119, 2004.

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