Non-tuberculous mycobacterium in chronic breast lesions in a tertiary care hospital in Dhaka, Bangladesh

Abstract

Mycobacterial association in breast lesions with or without abscess is often overlooked and misdiagnosed as carcinoma or pyogenic abscess because specimens are paucibacillary and investigations such as microscopy and culture are frequently negative. Over the past few decades incidence of infection caused by non-tuberculous mycobacterium (NTM) has increased worldwide. Sometimes NTM infection is misdiagnosed as tuberculosis because NTM can also produce granulomatous lesion and take acid fast bacilli (AFB) stain like mycobacterium tuberculosis (MTB). We previously reported presence of NTM in variety of clinical specimens from patients attended in our hospital. This time we evaluated mycobacterium tuberculosis (TB) complex and NTM by real time PCR in chronic primary breast lesions in 45 patients attended in our hospital. The target DNA sequences were amplified with IS6110-specific primers for MTB complex and ITS-specific primers for NTM. NTM was detected in 4 breast biopsy tissues, 3 nipple discharge and 2 breast ulcer specimens from 9 patients (20%) and MTB was detected in pus and fluid aspirate from 2 (4.44%) patients out of total 45 patients. Histopathology record of 7 NTM PCR positive specimens showed 5 granulomatous mastitis, 2 fibrocystic diseases. These data show high association of NTM in chronic breast lesions for the first time in the country which were responded well by combination of clarithromycin and ciprofloxacin and warrants large scale study.