Chronic otitis media caused by Mycobacterium abscessus spp. massiliense treated with tigecycline in a 10-year-old child

Abstract

Mycobacterium abscessus is one of the most pathogenic and chemotherapy-resistant rapidly growing mycobacteria. This Mycobacterium should always be considered as a possible cause of chronic otitis media in children, and treatment might be challenging because of its resistance to multiple antibiotics. There are no reports describing the therapeutic use of tigecycline for the treatment of chronic otitis media caused by M. abscessus. A 10-year-old boy was referred to Tokyo Metropolitan Children's Medical Center with a 7-year history of recurrent otitis media despite treatment with antibiotics and ventilation tubes. Cultures of the otorrhea yielded Mycobacterium abscessus spp. massiliense, and it showed multiple and high-level resistance. The boy required surgery and underwent initial treatment with clarithromycin, amikacin, and tigecycline for 4 weeks. He experienced emesis as a side-effect of tigecycline, which was well controlled with ondansetron. He was treated successfully with 3 months of subsequent oral clarithromycin and linezolid. This is the first pediatric case of chronic otitis media caused by M. abscessus treated with a tigecycline-containing regimen. Although the therapeutic use of tigecycline remains controversial, especially in the pediatric population, it can be an acceptable option in the treatment of chronic otitis media caused by M. abscessus.

Biological Functions and Molecular Mechanisms of Antibiotic Tigecycline in the Treatment of Cancers

“…As an FDA-proved drugs for infection treatment, this drug may be used in cancer treatment in the future. Although it also has some side effects, such as hypofibrinogenemia [100], mitochondrial dysfunction [101], chronic otitis [102], and gastrointestinal symptoms such as nausea, vomiting, and diarrhea [103], we cannot ignore its important potential promise in anticancer therapy [104]. A clinical study on tigecycline antibacterial activity shows that once daily high dose this drug, i.e., 200–400 mg (IV) × 1, then 100–200 mg (IV) q24 h, can effectively eliminate the multi-drug resistant (MDR) Klebsiella Pneumoniae in the urine in 5 days and Enterobacter aerogenes in 12 days without gastrointestinal or other side effects [105].…”

Delineating Mycobacterium abscessus population structure and transmission employing high-resolution core genome multilocus sequence typing

“…Mab can also cause extra-pulmonary disease such as skin and soft tissue infection (SSTI) in healthy persons and sporadically otitis media (ear infections) in children 16 . Many SSTI outbreaks affecting multiple individuals have been related to surgical or cosmetic procedures likely due to contaminated water sources or medical devices, e.g.…”

A first case report of nasopharyngeal Mycobacterium abscessus subspecies massiliense infection

“…The M. abscessus complex, including M. massiliense , commonly causes skin, soft tissue as well as pulmonary infections [ 5 ]. Although there are reports of M. massiliense infection in the head and neck region, such as otitis media [ 6 ], there are no reports of nasopharyngitis caused by this pathogen. We here report, to our knowledge, the first case of nasopharyngeal M. massiliense infection.…”