Mycobacterium interjectumLung Infection

Abstract

A 62-year-old male presented with productive cough, weight loss, and night sweats. CXR revealed a right upper lobe cavitary lesion. Evaluation was negative for Mycobacterium tuberculosis, and sputum revealed Mycobacterium avium intracellulare (MAI). Since his clinical course was atypical for MAI, further investigations were pursued which identified Mycobacterium interjectum in lung specimens, a very rarely described etiology of pulmonary disease. Appropriate therapy with rifampin, intravenous amikacin, trimethoprim/sulfamethoxazole (TMP/SMX), and ethambutol resulted in clinical and radiographic improvement. This is the third case described over a period of 20 years of destructive lung disease in an immunocompetent adult due to M. interjectum.

DisseminatedMycobacterium interjectumInfection with Bacteremia, Hepatic and Pulmonary Involvement Associated with a Long-Term Catheter Infection

“…The identification of mycobacteria was traditionally based upon phenotypic and biochemical characteristics, nucleic acid probes (available for only a limited number of NTM), and high-performance liquid chromatography [ 7 ], all of which have been largely supplanted by 16S rRNA sequencing [ 8 ]. M. interjectum identification has been unsuccessful with biochemical and phenotypic techniques [ 7 ], since it has similar characteristics with other mycobacteria such as M. scrofulaceum , M. gordonae , and M. simiae [ 5 , 7 , 9 ]. Species level identification usually requires 16S rRNA gene sequencing [ 5 , 7 ], although use of sequence data from the hsp65 or rpoB genes has been described to be valuable tool in AFB identification [ 8 , 10 ].…”

“…M. interjectum has also been isolated in sputum cultures of asymptomatic patients [ 7 , 13 ] and from the gastrointestinal tract in a patient with acquired immunodeficiency syndrome [ 14 ]. In adults, infection with M. interjectum has been reported with pulmonary infection [ 5 , 15 , 16 ], cutaneous infection [ 17 ], and meningitis [ 18 ] ( Table 1 ).…”

“…Fukuoka et al successfully treated an isolated M. interjectum cutaneous infection with surgical intervention alone in a patient with microscopic polyangiitis on chronic steroid and azathioprine therapy [ 17 ]. Pulmonary and meningeal infections have previously been treated with prolonged courses of combined antibiotic therapy [ 5 , 18 ]. M. interjectum is known to be multidrug resistant [ 17 ].…”

“…Advances in mycobacteriology techniques have allowed the identification of new NTM species [ 1 ], previously undiagnosed or misclassified [ 2 , 3 ]. Mycobacterium interjectum is an uncommon pathogen that has been associated with lymphadenitis in children and pulmonary involvement in adults [ 4 , 5 ]. There are currently no specific guidelines for management of this uncommon infection.…”

Draft Genome Sequence of Mycobacterium interjectum Strain ATCC 51457 T

“…nov. ( 4 ). M. interjectum is an opportunistic pathogen mainly isolated from diseased lymph nodes ( 1 , 5 – 8 ) and the respiratory tract ( 5 , 9 – 11 ). A few other cases have caused meningoencephalitis ( 12 ) and cutaneous infection ( 13 ).…”