Mycobacterium abscessus as a Cause of Chronic Meningitis: A Rare Clinical Entity

Baidya, Ankita; Tripathi, Manjul; Pandey, Pooja; Singh, Urvashi

doi:10.1016/j.amjms.2016.02.009

Cited by 16 publications

(7 citation statements)

References 7 publications

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“…Table 4 summarizes cases isolated from CNS after VP shunt insertion. There are two other reported cases of VP shunt infection due to M. abscessus, a 30 yr. old male with hydrocephalus [53] and a 59-year-old man with hydrocephalus [54] (reported by us previously). Post insertion of VP shunt, the patients presented with meningeal signs and symptoms; but time duration for onset of symptoms varied from 8 days to months and in two cases, 16 and 30 years [55][56][57][58].…”

Section: Non-tuberculous Mycobacteria and Healthcare-associated Meninmentioning

confidence: 71%

Healthcare-Associated Meningitis Caused byM. tuberculosisand Non-Tuberculous Mycobacteria

Xess¹,

Bala²,

Singh³

2020

Disorders of Consciousness - A Review of Important Issues

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Meningitis can be acquired in the community setting or secondary to invasive procedures or head trauma. The latter group has been classified as health-careassociated meningitis because the etiologic agents belong to a different spectrum of microorganisms, including Staphylococcus aureus, Coagulase negative staphylococcus Gram negative bacilli, Aspergillus, Candida albicans, Cryptococcus neoformans. IDSA Clinical Practice guidelines for Healthcare-associated ventriculitis and meningitis does not include M. tuberculosis and NTM, but in the last decade infections caused by these organisms are on a rise. These infections are mostly associated with cerebrospinal fluid shunts, cerebrospinal fluid drains, intra-thecal drug therapy, deep brain stimulation hardware, neurosurgery and head trauma. Most commonly these are introduced during surgical procedures. Another important pathogenic factor is biofilm formation that increases the persistence and resistance to antibiotic therapy, hence the survival. A high index of suspicion aids early diagnosis but preventive measures such as care of the devices introduced into sterile spaces is essential. Sterilization of the critical items is recommended by treating with different chemical sterilizing agents but most importantly meticulous cleaning must precede any high-level disinfection or sterilization process. A course of multidrug therapy is required for prolonged period of time depending on mycobacterial species.

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Section: Non-tuberculous Mycobacteria and Healthcare-associated Meninmentioning

confidence: 71%

Healthcare-Associated Meningitis Caused byM. tuberculosisand Non-Tuberculous Mycobacteria

Xess¹,

Bala²,

Singh³

2020

Disorders of Consciousness - A Review of Important Issues

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“…Other isolated reports of CNS infections after VP shunt insertions are summarised in table 2. Two cases of VP shunt infection have been reported due to M. abscessus : a 30-year-old man with hydrocephalus2 and a 59-year-old man also with hydrocephalus3 (our previous report). Postinsertion of VP shunt, the patients presented with meningeal signs and symptoms, and the duration of onset of symptoms varied from 8 days to months, and in two cases 16 and 30 years 4–7.…”

Section: Discussionmentioning

confidence: 90%

Mycobacterium fortuitumas a cause of acute CNS infection in an immune-competent girl undergoing repeated VP shunt surgeries

et al. 2019

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We present the case of a 14-year-old immune-competent girl with ventriculoperitoneal shunt who was repeatedly hospitalised with meningeal signs despite repeated shunt revision surgeries. Eventually Mycobacterium fortuitum was isolated and the patient improved after specific treatment. M. fortuitum is a rapidly growing, non-tuberculous mycobacterium (NTM). NTMs are associated with postsurgical, post-trauma and device-related infections. Most of the present-day surgical equipment, catheters, prostheses and indwelling devices comprised silicone, stainless steel, polyvinyl chloride and polycarbonate, on which NTMs have the tendency to form biofilms. Central nervous system infection caused by NTM carries a high mortality rate (ranging from 35% to 70%), especially in immune-compromised patients. Indwelling device removal along with prolonged treatment with a combination regimen is recommended in such cases.

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“…Recurrence of infection forced further treatment and full eradication was achieved only after a third ventriculostomy along with a prolonged regimen of systemic antimicrobials [2,5]. Evidence suggests that the pathogen's ability to produce a biofilm explains its long latent period and makes infection resolution without removal of the infected foreign material very difficult [1].…”

Section: Discussionmentioning

confidence: 99%

“…Unlike other non-tuberculous mycobacteria, RGM is typically resistant to first-line anti-tuberculosis drugs. While it has emerged as the cause of an increasing number of community and hospital-acquired infections in people, central nervous system (CNS) infections caused by the organism are uncommon and have not been widely reported [1][2][3][4][5]. The pathogen has previously been associated with skin and soft tissue infections, as well as with pulmonary disease in immunocompromised individuals.…”

Section: Introductionmentioning

confidence: 99%

Mycobacterium abscessus Ventriculoperitoneal Shunt Infection

Herrera¹,

Danyalian²,

Kaswan³

et al. 2021

Cureus

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Mycobacterium abscessus is a rapidly growing mycobacterium (RGM) known to be abundant in soil, dust and water. Unlike other non-tuberculous mycobacteria, RGM is typically resistant to first-line anti-tuberculosis drugs. These organisms are known to cause community and hospital-acquired infections; however, central nervous system (CNS) infections caused by these pathogens have not been abundantly reported. As the use of vascular catheters and prosthetic devices is becoming more common, a rise in CNS infections secondary to M. abscessus has been noted. Here, we present such a case where the removal of a ventricular catheter was necessary to guarantee source control and eradication of the infection.

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Mycobacterium abscessus as a Cause of Chronic Meningitis: A Rare Clinical Entity

Cited by 16 publications

References 7 publications

Healthcare-Associated Meningitis Caused byM. tuberculosisand Non-Tuberculous Mycobacteria

Healthcare-Associated Meningitis Caused byM. tuberculosisand Non-Tuberculous Mycobacteria

Mycobacterium fortuitumas a cause of acute CNS infection in an immune-competent girl undergoing repeated VP shunt surgeries

Mycobacterium abscessus Ventriculoperitoneal Shunt Infection

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