Disseminated Mycobacterium abscessus infection with idiopathic CD4+ T-lymphocytopenia: a case report and review of the literature

Idiopathic CD4+ T lymphocytopenia is a rare immune dysfunction disease that is usually found after opportunistic infections. Mycobacterium abscessus is a rapidly growing mycobacterium that can cause pulmonary infections, lymphadenitis, skin and soft tissue infections, disseminated infections, among others, as a conditional pathogenic bacterium. We present the case of a 43-year-old Chinese woman who developed disseminated Mycobacterium abscessus infection due to idiopathic CD4+ T lymphocytopenia. The patient exhibited symptoms including skin infections, lymphadenitis, and bacteremia. A tailored multidrug therapy was initiated, guided by drug susceptibility testing. Within a month of treatment, the patient's fever resolved, and she exhibited a significant recovery and was discharged. Cases of clinical idiopathic CD4+ T lymphocytopenia with Mycobacterium abscessus infection are not common. Clinicians should be vigilant and accurately identify Mycobacterium abscessus as an opportunistic pathogen when dealing with immunocompromised patients, in particular with idiopathic CD4+ T lymphocytopenia.