Mycobacterium Avium Complex: A Rare Cause of Pancytopenia in HIV Infection

Opportunistic infections in HIV infection are challenging to diagnose and treat, especially when the prevalence of disease is rare. Mycobacterial infections can have debilitating morbidity and mortality in HIV individuals if prompt diagnosis and treatment is not done. A 33-year-old African-American female presented for the complaints of easy fatigability, unintentional weight loss, and diarrhea of 3-month duration. Initial laboratory results suggested bicytopenia; however, there was an initial delay of a couple of months in evaluation because of her poor compliance. A final diagnosis of HIV with a low CD4 count of 9 cells/mm(3) and disseminated Mycobacterium avium complex (MAC) infection was made. She was started on anti-MAC therapy, followed by antiretroviral therapy however soon succumbed to her illness.