Non-tuberculous mycobacteria (NTM) such as Mycobacterium avium intracellulare are commonly encountered by HIV physicians and management strategies are well established. Experience of other NTM is, however, limited. As HIV epidemiology in the United Kingdom changes, we may expect the emergence of these lesser known mycobacterial infections. We present the first UK report of an AIDS patient who has survived infection with disseminated Mycobacterium simiae despite cerebrospinal fluid involvement, an extremely high level of baseline HIV viraemia and treatment complicated by severe immune reconstitution inflammatory syndrome.
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