Disseminated Mycobacterium avium complex presenting with solitary splenic abscess in an immunocompromised patient.

This article focuses on a rare case of a solitary splenic abscess caused by disseminated Mycobacterium avium complex (MAC) infection in a 35-year-old man with advanced human immunodeficiency virus (HIV). MAC, a common opportunistic infection in advanced HIV, typically involves multiple organs but rarely forms solitary splenic abscesses. The patient's diagnosis was confirmed through cultures and biopsies, and he was treated with a combination of rifabutin, ethambutol, azithromycin, and antiretroviral therapy (ART), alongside management of concurrent cytomegalovirus viremia and esophageal candidiasis. This case underscores the importance of considering atypical focal infections like splenic abscesses in severely immunocompromised patients and highlights the complexities of diagnosis and treatment in disseminated MAC with coexisting opportunistic infections.