Concurrent cytomegalovirus, M. tuberculosis and M. avium-intracellulare cutaneous infection in an HIV patient.

We report a 25-year-old HIV-positive man with a past medical history of disseminated cytomegalovirus (CMV) infection, who developed cutaneous lesions during a disseminated mycobacterium infection. The histological changes of CMV and acid-fast bacilli were seen on histopathology of the lesions. Cultures were positive for M. tuberculosis and M. avium-intracellulare (MAI). CMV is frequently isolated from HIV patients, but skin involvement is rare. The association of CMV and mycobacteria can occur in cutaneous lesions of AIDS patients, but concurrent cutaneous involvement of CMV, M. tuberculosis, and MAI is unusual. These findings emphasize the polymorphous presentation of infectious disorders in AIDS patients and the need for multiple biopsies and for special stains in such patients.