scholarly journals Extensive Mycobacterium abscessus Pneumonia in an Immunocompetent Infant with No Underlying Lung Pathology

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Morouge M. Alramadhan ◽  
James R. Murphy ◽  
Michael L. Chang
Keyword(s):  
Pulmonary Infection ◽  
Failure To Thrive ◽  
Mycobacterium Abscessus ◽  
Review Literature ◽  
Lung Pathology ◽  
Susceptibility Pattern ◽  
Complete Evaluation ◽  
Whole Exome ◽  
Acquired Immunodeficiency ◽  
Immunocompetent Infant

Pulmonary infection due to Mycobacterium abscessus occurs in patients with cystic fibrosis, but rarely in immunocompetent children without underlying lung pathology. Treatment is complicated by frequent resistance to many antibiotics. We present a case report of a 4-month-old female infant with 2 months of cough, difficulty feeding, and failure to thrive, with extensive culture-confirmed M. abscessus pulmonary infection without identified immunodeficiency or underlying lung pathology following multidisciplinary evaluation. We describe our complete evaluation including immunodeficiency evaluation incorporating whole-exome sequencing, describe our antibiotic selection and treatment duration given complicated susceptibility pattern of the M. abscessus isolate, and review literature for nontuberculous mycobacterial pulmonary disease in immunocompetent children. A complete multidisciplinary evaluation for underlying lung disease and primary and acquired immunodeficiency should be undertaken in pediatric patients with M. abscessus pneumonia. Confirming macrolide susceptibility through erm(41) gene evaluation is clinically important for isolates with complicated susceptibility pattern.

Pathologic Features of Mycobacterium kansasii Infection in Patients With Acquired Immunodeficiency Syndrome

2003 ◽  
Vol 127 (5) ◽  
pp. 554-560 ◽  
Author(s):  
Michael B. Smith ◽  
Claudia P. Molina ◽  
Vicki J. Schnadig ◽  
Michael C. Boyars ◽  
Judith F. Aronson
Keyword(s):  
Lymph Node ◽  
Acquired Immunodeficiency Syndrome ◽  
Pulmonary Infection ◽  
Mycobacterium Kansasii ◽  
Abdominal Lymph Node ◽  
Inflammatory Reactions ◽  
Pathologic Features ◽  
Wide Range ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

Abstract Context.—Mycobacterium kansasii is a slow-growing photochromogenic mycobacterium that may infect patients with human immunodeficiency virus (HIV) late in the course of acquired immunodeficiency syndrome (AIDS). The clinical features of pulmonary and extrapulmonary infections have been described in the literature; however, the pathology of infection has not been adequately addressed. Objective.—This report describes the pathologic features of 12 cases of M kansasii infection in patients with AIDS. Design.—The medical records, autopsy protocols, cytologic material, and histologic material from patients with AIDS and concomitant M kansasii infection at a tertiary-care medical center during 1990–2001 were reviewed. Results.—Twelve cases were identified, 6 by autopsy, 5 of which were diagnosed postmortem. Four of the 12 cases had cytologic material and 4 cases had histologic biopsies available for review. Pulmonary infection was most common (9/12), and all patients in whom thoracic lymph nodes were assessed showed involvement (7/7). Abdominal infection was less frequent, with only 1 of 6, 2 of 6, and 2 of 6, demonstrating liver, spleen, and abdominal lymph node infection, respectively. Isolated infections without documented pulmonary infection included brain abscess (n = 1), ulnar osteomyelitis (n = 1), and paratracheal mass (n = 1). Cytologic and histologic material showed a wide range of inflammatory reactions, including granulomas with and without necrosis, neutrophilic abscesses, spindle-cell proliferations, and foci of granular eosinophilic necrosis. The M kansasii bacillus was characteristically long, coarsely beaded, and frequently showed folded, bent, or curved ends. Intracellular bacilli were randomly or haphazardly distributed within histiocytes. Conclusion.—Mycobacterium kansasii infection produces predominately pulmonary infection in late-stage AIDS with a high incidence of thoracic lymph node involvement and a much lower incidence of dissemination to other sites. Infection is manifest as a wide variety of inflammatory reactions on cytology and histology; however, the characteristic appearance of the bacillus on acid-fast bacilli stain and its intracellular arrangement in histiocytes can allow a presumptive identification.

scholarly journals Mycobacterium abscessus Pulmonary Infection Presenting as a Solitary Pulmonary Nodule

2006 ◽  
Vol 45 (3) ◽  
pp. 169-171 ◽  
Author(s):  
Yong Soo Kwon ◽  
WonJung Koh ◽  
O Jung Kwon ◽  
Nam Yong Lee ◽  
Joungho Han ◽  
...  
Keyword(s):  
Pulmonary Nodule ◽  
Pulmonary Infection ◽  
Solitary Pulmonary Nodule ◽  
Mycobacterium Abscessus

scholarly journals Eradication of Mycobacterium abscessus Pulmonary Infection in a Child With Idiopathic Bronchiectasis

2016 ◽  
Vol 3 ◽  
pp. 2333794X1667098
Author(s):  
Sarah K. Anisowicz ◽  
Sebastian K. Welsh ◽  
Jane E. Gross
Keyword(s):  
Pulmonary Infection ◽  
Mycobacterium Abscessus

scholarly journals A resected case of pulmonary infection caused by Mycobacterium abscessus

2010 ◽  
Vol 24 (7) ◽  
pp. 1055-1059
Author(s):  
Teruo Iwata ◽  
Masaaki Inoue ◽  
Takashi Iwanami ◽  
Hiroyuki Moriyama ◽  
Makoto Kawaguchi ◽  
...  
Keyword(s):  
Pulmonary Infection ◽  
Mycobacterium Abscessus ◽  
Resected Case

scholarly journals A Case of Erosive Polyarthritis in a Patient Diagnosed With a Suspicion of Atypical Mycobacteria

2013 ◽  
Vol 7 (1) ◽  
pp. 64-66 ◽  
Author(s):  
Hani Almoallim ◽  
Laila Alharbi ◽  
Zainab Alshareef ◽  
Ghassan Wali
Keyword(s):  
Pulmonary Infection ◽  
Mycobacterium Abscessus ◽  
Significant Response ◽  
Atypical Mycobacteria ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Disease Modifying ◽  
Antimicrobial Regimen

In this report, we introduce a case of erosive polyarthritis in a 55-year-old female diagnosed with Mycobacterium abscessus pulmonary infection. Her arthritis has been worsened after use of DMARDs. The patient demonstrated a significant response to the antimicrobial regimen that was administered. We call special attention to the possibility of Mycobacterium abscessus being a cause of reactive polyarthritis, particularly if symptoms worsened after use of disease-modifying antirheumatic drugs (DMARDs), but further studies are necessary for clarification.

scholarly journals Clinical Outcomes of Clofazimine Use for Rapidly Growing Mycobacterial Infections

2019 ◽  
Author(s):  
George B Carey ◽  
Pablo Tebas ◽  
Christopher Vinnard ◽  
Deborah Kim ◽  
Denis Hadjiliadis ◽  
...  
Keyword(s):  
Clinical Cure ◽  
Pulmonary Infection ◽  
Mycobacterium Abscessus ◽  
University Of Pennsylvania ◽  
The University ◽  
Antibiotic Agents ◽  
Vitro Data ◽  
In Vitro Data ◽  
Infection Recurrence

Abstract Background Rapidly growing mycobacteria (RGM) have high rates of intrinsic antibiotic resistance and require prolonged antibiotic therapies associated with considerable toxicity. Less toxic and more effective therapies are needed. One promising agent is clofazimine (CFZ), an antibiotic with favorable in vitro data but limited clinical data in RGM. Methods We performed a retrospective cohort study of all patients treated for RGM infection with a CFZ-containing regimen in the University of Pennsylvania Health System between 1/1/2010 and 12/31/2016. Primary outcome was clinical cure, defined as no evidence of clinical or microbiologic infection recurrence after 1 year following the completion of treatment. Secondary outcomes included clinical, radiologic, and microbiologic response; all-cause mortality; infection-specific mortality; and treatment-related adverse events. Descriptive and unadjusted analyses were performed to elucidate associations between pertinent demographic and comorbidity data, clinical presentation, treatment history, and treatment outcomes. Results We treated 55 patients with CFZ for RGM infection during the study period in combination with a median of 5 other antibiotic agents during each treatment course. Clinical cure with initial treatment regimen was achieved in 43% of patients with pulmonary infection and 71% of patients with non-pulmonary infection. CFZ was well tolerated in our cohort and was discontinued prematurely in 20% of patients, but only in the context of discontinuing all antibiotic agents. Conclusions As part of multidrug therapy, CFZ is well tolerated and may be effective in patients with RGM infection, especially non-pulmonary and non-Mycobacterium abscessus complex infections.

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