Disseminated Mycobacterium abscessus Mimicking Sarcoidosis: A Case of Successful Outcomes Against Clinical Expectations

Mycobacterium (M.) abscessus infections are challenging to treat because there are no drug combinations with proven efficacy. As with other mycobacterioses, disseminated infection caused by M. abscessus in immunocompetent individuals can be mistaken for other granulomatous diseases, specifically sarcoidosis. Both diseases can affect virtually any organ and share many clinical manifestations. We present the case of a woman with a confirmed M. abscessus disseminated infection, but whose progression exhibited clinical characteristics and a response to treatment very similar to that of sarcoidosis. However, the cutaneous and ocular manifestations were a therapeutic challenge considering that the patient presented an intolerance and adverse events to antimicrobials and a partial refractoriness to systemic corticosteroids. A possible link between these two diseases is discussed, and it is recommended that in cases of disseminated M. abscessus infections in immunocompetent individuals, with treatment failure, the possibility of sarcoidosis-like behavior must be reconsidered.