1887

Journal of Medical Microbiology logo

Volume 57, Issue 5

empyema in an immunocompetent patient Free

Abstract

Thoracic empyema caused by rapidly growing mycobacteria (RGM) and complicated with bronchopleural fistula is rarely reported, especially in immunocompetent patients. A 53-year-old healthy woman presented initially with a productive cough and intermittent fever. The patient received a complete treatment course following an initial diagnosis of pulmonary tuberculosis. After the anti-tuberculosis agents were discontinued, a right thoracic empyema with bronchopleural fistula occurred, and the pathogens from both pus and sputum were identified as . Thoracotomy with decortication and wedge resection of the right middle lung was performed, followed by clarithromycin plus ciprofloxacin therapy for 36 months. This patient has not suffered a relapse in the last 3 years. In addition to the experience of successful treatment, this case indicates that RGM such as can emerge as causative pathogens of thoracic empyema, even in healthy persons.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): NTM, non-tuberculosis mycobacteria and RGM, rapidly growing mycobacteria
SGM
Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.47574-0
2008-05-01
2024-04-28
Loading full text...

Full text loading...

/deliver/fulltext/jmm/57/5/664.html?itemId=/content/journal/jmm/10.1099/jmm.0.47574-0&mimeType=html&fmt=ahah

References

  1. American Thoracic Society. 1997; Diagnosis and treatment of disease caused by nontuberculous mycobacteria. Am J Respir Crit Care Med 156:S1–S25 [CrossRef]
     [Google Scholar]
  2. Aronchick J. M., Miller W. T., Epstein D. M., Gefter W. B. 1986; Association of achalasia and pulmonary Mycobacterium fortuitum infection. Radiology 160:85–86 [CrossRef]
     [Google Scholar]
  3. Brown-Elliott B. A., Wallace R. J. Jr 2002; Clinical and taxonomic status of pathogenic nonpigmented or late-pigmenting rapidly growing mycobacteria. Clin Microbiol Rev 15:716–746 [CrossRef]
     [Google Scholar]
  4. Chalermskulrat W., Gilbey J. G., Donohue J. F. 2002; Nontuberculous mycobacteria in women, young and old. Clin Chest Med 23:675–686 [CrossRef]
     [Google Scholar]
  5. Dalovisio J. R., Pankey G. A., Wallace R. J., Jones D. B. 1981; Clinical usefulness of amikacin and doxycycline in the treatment of infection due to Mycobacterium fortuitum and Mycobacterium chelonei . Rev Infect Dis 3:1068–1074 [CrossRef]
     [Google Scholar]
  6. Driscoll M. S., Tyring S. K. 1997; Development of resistance to clarithromycin after treatment of cutaneous Mycobacterium chelonae infection. J Am Acad Dermatol 36:495–496 [CrossRef]
     [Google Scholar]
  7. Fairhurst R. M., Kubak B. M., Shpiner R. B., Levine M. S., Pegues D. A., Ardehali A. 2002; Mycobacterium abscessus empyema in a lung transplant recipient. J Heart Lung Transplant 21:391–394 [CrossRef]
     [Google Scholar]
  8. Franck N., Cabie A., Villette B., Amor B., Lessana-Leibowitch M., Escande J. P. 1993; Treatment of Mycobacterium chelonae -induced skin infection with clarithromycin. J Am Acad Dermatol 28:1019–1021 [CrossRef]
     [Google Scholar]
  9. Griffith D. E., Girard W. M., Wallace R. J. Jr 1993; Clinical features of pulmonary disease caused by rapidly growing mycobacteria. An analysis of 154 patients. Am Rev Respir Dis 147:1271–1278 [CrossRef]
     [Google Scholar]
  10. Hazelton T. R., Newell J. D., Cook J. L., Huitt G. A., Lynch D. A. 2000; CT findings in 14 patients with Mycobacterium chelonae pulmonary infection. AJR Am J Roentgenol 175:413–416 [CrossRef]
     [Google Scholar]
  11. Kressel A. B., Kidd F. 2001; Pseudo-outbreak of Mycobacterium chelonae and Methylobacterium mesophilicum caused by contamination of an automated endoscopy washer. Infect Control Hosp Epidemiol 22:414–418 [CrossRef]
     [Google Scholar]
  12. McFarland E. J., Kuritzkes D. R. 1993; Clinical features and treatment of infection due to Mycobacterium fortuitum/chelonae complex. Curr Clin Top Infect Dis 13:188–202
     [Google Scholar]
  13. Mushatt D. M., Witzig R. S. 1995; Successful treatment of Mycobacterium abscessus infections with multidrug regimens containing clarithromycin. Clin Infect Dis 20:1441–1442 [CrossRef]
     [Google Scholar]
  14. Telenti A., Marchesi F., Balz M., Bally F., Böttger E. C., Bodmer T. 1993; Rapid identification of mycobacteria to the species level by polymerase chain reaction and restriction enzyme analysis. J Clin Microbiol 31:175–178
     [Google Scholar]
  15. Wallace R. J. Jr, Swenson J. M., Silcox V. A., Good R. C., Tschen J. A., Stone M. S. 1983; Spectrum of disease due to rapidly growing mycobacteria. Rev Infect Dis 5:657–679 [CrossRef]
     [Google Scholar]
  16. Wallace R. J. Jr, Brown B. A., Onyi G. O. 1992; Skin, soft tissue and bone infections due to Mycobacterium chelonae chelonae : importance of prior corticosteroid therapy, frequency of disseminated infections, and resistance to oral antimicrobials other than clarithromycin. J Infect Dis 166:405–412 [CrossRef]
     [Google Scholar]
  17. Wallace R. J. Jr, Tanner D., Brennan P. J., Brown B. A. 1993; Clinical trial of clarithromycin for cutaneous (disseminated) infection due to Mycobacterium chelonae . Ann Intern Med 119:482–486 [CrossRef]
     [Google Scholar]
  18. Yang S. C., Hsueh P. R., Lai H. C., Teng L. J., Huang L. M., Chen J. M., Wang S. K., Shie D. C., Ho S. W., Luh K. T. 2003; High prevalence of antimicrobial resistance in rapidly growing mycobacteria in Taiwan. Antimicrob Agents Chemother 47:1958–1962 [CrossRef]
     [Google Scholar]
  19. Zahid M. A., Klotz S. A., Goldstein E., Bartholomew W. 1994; Mycobacterium chelonae ( M. chelonae subspecies chelonae ): report of a patient with a sporotrichoid presentation who was successfully treated with clarithromycin and ciprofloxacin. Clin Infect Dis 18:999–1001 [CrossRef]
     [Google Scholar]
  20. Zaleznik D. F., Quinn T. R. 1996; Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 33–1996 – a 55-year-old man with a long-term tracheostomy and acid-fast bacilli in peristomal granulations. N Engl J Med 335:1303–1307 [CrossRef]
     [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.47574-0
Loading
Mycobacterium chelonae empyema in an immunocompetent patient
J. Med. Microbiol. 57, 664 (2008); https://doi.org/10.1099/jmm.0.47574-0
/content/journal/jmm/10.1099/jmm.0.47574-0
/content/journal/jmm/10.1099/jmm.0.47574-0
Loading

Data & Media loading...

Most cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error