Disseminated infection caused by Mycobacterium sherrisii in an HIV-negative patient from China: A case report and literature review

OBJECTIVES: It has been 20 years since the first identification of Mycobacterium sherrisii in 2004. However, the rare and nonspecific clinical infection cases by this bacterium have not been well summarized and systematically analyzed, posing significant challenges for the diagnosis and treatment of M. sherrisii infection. CASE PRESENTATION: We detail the case of a 54-year-old HIV-negative Chinese female who presented with systemic symptoms including fatigue, recurrent fever, and diffuse bone pain, initially raising suspicion for malignancy. She had undergone right-sided cervical acupuncture, followed by persistent lymphadenopathy with subcutaneous emphysema. Imaging revealed multiorgan involvement, including lymph nodes, esophagus, lung, heart, and bones. Following the detection of acid-fast bacilli in lymph node and bone marrow specimens by fluorescent staining, isolates obtained from cultures of pericardial effusion, sputum, and pleural fluid were ultimately identified as M. sherrisii through hsp65 gene sequencing and whole-genome sequencing, further confirming its genetic stability. After a full year of treatment based on drug susceptibility testing results, the patient recovered successfully and has shown no recurrence. CONCLUSION: This case highlights the diagnostic challenge of an atypical-disseminated M. sherrisii infection in a non-HIV patient, with acupuncture identified as the probable portal of entry. Successful management requires individualized therapy based on drug susceptibility testing results. Furthermore, we review 26 published cases (including this study) to better characterize the epidemiology and clinical features of this rare species.