Disseminated Mycobacterium abscessus infection and native valve endocarditis
Mycobacterium abscessus is a rapidly growing mycobacterium. It rarely causes disseminated infection or endocarditis. A 55-year-old male with a history of hepatitis C, liver cirrhosis, intravenous drug use (last use was four years ago), and chronic back pain presented with a three-week history of a r...
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doaj-15c3b66f0e30404ab10865365e5f28532021-03-22T12:49:49ZengElsevierRespiratory Medicine Case Reports2213-00712021-01-0132101331Disseminated Mycobacterium abscessus infection and native valve endocarditisMandeep Singh Rahi0Sandra Patrucco Reyes1Jay Parekh2Kulothungan Gunasekaran3Kwesi Amoah4Daniel Rudolph5Division of Pulmonary Diseases and Critical Care Medicine, Yale-New Haven Health Bridgeport Hospital, Bridgeport, CT, USA; Corresponding author. Division of Pulmonary Diseases and Critical Care Medicine, Yale-New Haven Health Bridgeport Hospital, 267 Grant Street, Bridgeport, CT, 06610, USA.Department of Internal Medicine, Yale-New Haven Health Bridgeport Hospital, Bridgeport, CT, USADepartment of Internal Medicine, Yale-New Haven Health Bridgeport Hospital, Bridgeport, CT, USADivision of Pulmonary Diseases and Critical Care Medicine, Yale-New Haven Health Bridgeport Hospital, Bridgeport, CT, USADivision of Pulmonary Diseases and Critical Care Medicine, Yale-New Haven Health Bridgeport Hospital, Bridgeport, CT, USADivision of Pulmonary Diseases and Critical Care Medicine, Yale-New Haven Health Bridgeport Hospital, Bridgeport, CT, USAMycobacterium abscessus is a rapidly growing mycobacterium. It rarely causes disseminated infection or endocarditis. A 55-year-old male with a history of hepatitis C, liver cirrhosis, intravenous drug use (last use was four years ago), and chronic back pain presented with a three-week history of a right calf nodular lesion. He did not have a fever, chills, rash, dyspnea, or cough. Laboratory data showed mild leukocytosis. Computed tomography of the chest revealed bilateral cavitating nodules. Skin biopsy, sputum, and blood cultures grew Mycobacterium abscessus. Therapy with meropenem, tigecycline, and amikacin was initiated. He was re-admitted with worsening lower back pain. A lumbar magnetic resonance imaging showed destructive changes of L4 and L5 vertebral bodies concerning for osteomyelitis. Blood culture and bone biopsy grew Mycobacterium abscessus again. An echocardiogram was performed due to persistent bacteremia, which revealed large vegetation on the tricuspid valve and small vegetation on the mitral valve. Therapy was changed to eight weeks of amikacin, with cefoxitin and imipenem for twelve months based on drug susceptibility. Treatment of disseminated Mycobacterium abscessus is challenging due to antibiotic resistance. Typically, multidrug therapy is warranted with at least three active drugs. In severe valvular endocarditis, valve replacement may be required.http://www.sciencedirect.com/science/article/pii/S2213007120305451Mycobacterium abscessusEndocarditisPulmonary cavity |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mandeep Singh Rahi Sandra Patrucco Reyes Jay Parekh Kulothungan Gunasekaran Kwesi Amoah Daniel Rudolph |
spellingShingle |
Mandeep Singh Rahi Sandra Patrucco Reyes Jay Parekh Kulothungan Gunasekaran Kwesi Amoah Daniel Rudolph Disseminated Mycobacterium abscessus infection and native valve endocarditis Respiratory Medicine Case Reports Mycobacterium abscessus Endocarditis Pulmonary cavity |
author_facet |
Mandeep Singh Rahi Sandra Patrucco Reyes Jay Parekh Kulothungan Gunasekaran Kwesi Amoah Daniel Rudolph |
author_sort |
Mandeep Singh Rahi |
title |
Disseminated Mycobacterium abscessus infection and native valve endocarditis |
title_short |
Disseminated Mycobacterium abscessus infection and native valve endocarditis |
title_full |
Disseminated Mycobacterium abscessus infection and native valve endocarditis |
title_fullStr |
Disseminated Mycobacterium abscessus infection and native valve endocarditis |
title_full_unstemmed |
Disseminated Mycobacterium abscessus infection and native valve endocarditis |
title_sort |
disseminated mycobacterium abscessus infection and native valve endocarditis |
publisher |
Elsevier |
series |
Respiratory Medicine Case Reports |
issn |
2213-0071 |
publishDate |
2021-01-01 |
description |
Mycobacterium abscessus is a rapidly growing mycobacterium. It rarely causes disseminated infection or endocarditis. A 55-year-old male with a history of hepatitis C, liver cirrhosis, intravenous drug use (last use was four years ago), and chronic back pain presented with a three-week history of a right calf nodular lesion. He did not have a fever, chills, rash, dyspnea, or cough. Laboratory data showed mild leukocytosis. Computed tomography of the chest revealed bilateral cavitating nodules. Skin biopsy, sputum, and blood cultures grew Mycobacterium abscessus. Therapy with meropenem, tigecycline, and amikacin was initiated. He was re-admitted with worsening lower back pain. A lumbar magnetic resonance imaging showed destructive changes of L4 and L5 vertebral bodies concerning for osteomyelitis. Blood culture and bone biopsy grew Mycobacterium abscessus again. An echocardiogram was performed due to persistent bacteremia, which revealed large vegetation on the tricuspid valve and small vegetation on the mitral valve. Therapy was changed to eight weeks of amikacin, with cefoxitin and imipenem for twelve months based on drug susceptibility. Treatment of disseminated Mycobacterium abscessus is challenging due to antibiotic resistance. Typically, multidrug therapy is warranted with at least three active drugs. In severe valvular endocarditis, valve replacement may be required. |
topic |
Mycobacterium abscessus Endocarditis Pulmonary cavity |
url |
http://www.sciencedirect.com/science/article/pii/S2213007120305451 |
work_keys_str_mv |
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