Catheter‐related Mycobacterium abscessus bacteremia manifested with skin nodules, pneumonia, and mediastinal lymphadenopathy

Abstract

Although previously rare, catheter-related bloodstream infection caused by rapidly growing mycobacteria is now increasingly encountered, especially among cancer patients who have catheters implanted for chemotherapy treatments. A 73-year-old female patient with acute myeloid leukemia (AML) had Mycobacterium abscessus bacteremia with manifestations of multiple skin nodules, pneumonia, and mediastinal lymphadenopathy 4 months after the implantation of a peripherally inserted central catheter (PICC) for the delivery of chemotherapy. The catheter-related M. abscessus bacteremia was confirmed by positive blood cultures of specimens drawn from a PICC line and a peripheral vein. She defervesced with the administration of meropenem, amikacin, levofloxacin, clarithromycin, and by the removal of PICC. Her fever subsided for 3 months with the disappearance of skin and lung lesions; however, she died of AML relapse. Bacteremia and skin infection caused by M. abscessus can be detected by culture and pathological examinations and should be considered in leukemia patients with a PICC. With appropriate laboratory diagnosis, M. abscessus bacteremia with disseminated infections can improve with catheter removal and combination antimicrobial therapy.

Prolonged postprocedural outbreak of Mycobacterium massiliense infections associated with ultrasound transmission gel

“…Using the search terms '(Taiwan AND (Mycobacterium abscessus)) OR (Taiwan AND (Mycobacterium chelonae)),' we retrieved seven relevant articles from 70 results [21][22][23][24][25][26][27]. In addition to the CGMH cases, another case was retrieved from the records of the monthly meetings of the Infectious Diseases Society (http://www.idsroc.org.tw/DB/Cases/42/201/201.pdf).…”

Nontuberculous Mycobacteria

“…Patients present with systemic symptoms and often have multiple, red to violaceous, subcutaneous nodules, and lymphadenopathy. 91,92 Although most disseminated cutaneous disease is due to M chelonae, disseminated disease due to M abscessus is typically very serious and difficult to treat.…”

Sacroiliitis secondary to catheter-related bacteremia due to Mycobacterium abscessus (sensu stricto)

“…Disseminated infections are infrequent and occur especially in immunocompromised hosts [11]. Su et al [12] described a patient in whom catheter-related M. abscessus bacteremia was confirmed by positive blood cultures. M. abscessus infections have also been associated with injection of contaminated normal saline and drugs [12].…”

“…Su et al [12] described a patient in whom catheter-related M. abscessus bacteremia was confirmed by positive blood cultures. M. abscessus infections have also been associated with injection of contaminated normal saline and drugs [12]. Usually, the entry route in the organism is known.…”

“…Although no investigation was performed to confirm the presence of the same organism in the patient’s environment, the mycobacterial isolate could have been introduced in the blood circulation by contamination of the catheter through the injection of tap water. However, a secondary bone infection or osteomyelitis due to M. abscessus bacteremia is infrequent and, classically, M. abscessus bacteremia has an indolent course in patients and animal models [12]. In our case, the unusual severity of the disease (sacroiliitis) could have been caused by different factors, such as (i) the presence of a pre-existing sacroiliac joint lesion that could have facilitated the M. abscessus infection; (ii) the infection by a rough strain of M. abscessus with more virulence factors than smooth strains [15-17]; (iii) the lack of treatment after the identification of M. abscessus species in the catheter and blood specimens.…”