<em>Mycobacterium bovis</em> Infection: High Requirment for Surgical Interventions in HIV-Infected Subjects

Background: Zoonotic Mycobacterium bovis infection continues to occur, particularly in regions where there is no surveillance for bovine tuberculosis and raw milk consumption is common, or dairy products, including artisanal cheeses, are marketed unpasteurized. We describe the clinical and microbiological characteristics, procedures and treatment outcomes of subjects with M. bovis infection in HIV-infected individuals. Methods: A retrospective study was conducted obtaining the sociodemographic and clinical data, microbiological characteristics, CT findings and outcomes of 12 subjects with M. bovis infection which were compared these characteristics of 14 individuals with M. tuberculosis infection in HIV-infected subjects in the same period. Results: We found a significantly increased risk of M. bovis transmission due to consumption of unpasteurized dairy products and higher CD4+ T cells count in subjects with M. bovis infection vs M. tuberculosis infection ( p &amp;lt;0.0001 and 0.01 respectively). All subjects with M. bovis infection had extrapulmonary involvement. CT findings in M. ​​bovis infection that were significantly more frequent vs M tuberculosis infection were retroperitoneal lymphadenopathy, hepatosplenomegaly, and splenic abscesses. The site of microbiological identification was extrapulmonary in all M. bovis-infected subjects. Surgical interventions such as surgical drainage of abscesses or splenectomy were required significantly more frequently in subjects with M. bovis infection (p =0.0003). Conclusions: Extrapulmonary involvement, particularly with abdominal involvement, is routinely present in M. bovis infection in HIV-infected individuals. Surgical interventions are frequently required for diagnosis and management. Efforts to identify M. bovis should be made, particularly in high-burden regions.