Mycobacterium abscessus causing native valve endocarditis due to peripherally inserted central catheter line

Abstract

Infections due to rapidly-growing mycobacteria (RGM) are increasing worldwide, especially in immunocompromised hosts. However, data on the clinical features of patients with RGM bacteremia are limited [1]. Data on the incidence of clinically significant non-tuberculous mycobacteria (NTM) infections from India are scarce as these are frequently under-diagnosed due to either under recognition by clinicians because of the nonspecific nature of their clinical manifestations, and/or the inadequacy of laboratory services [2].We present a case of Mycobacterium abscessus native tricuspid valve endocarditis in a patient who had a peripherally inserted central catheter line (PICC).Clinicians need to be aware of RGM as a cause of prolonged fever in patients who have chronic indwelling intravenous catheters [3].

Severe hypercalcemia in a patient with extrapulmonaryMycobacterium abscessus: granuloma or immune reconstitution inflammatory syndrome? First case ofMycobacterium abscessuspresenting as retroperitoneal lymphadenopathy with severe hypercalcemia: a case report and literature review

“…Ocular infections can occur after medical interventions, trauma or implant and M. abscessus accounts for about 10% of NTM ocular infections [30]. M. abscessus bacteremia has been reported after prostate biopsy, disseminated form in a peritoneal dialysis patient, glossitis and in a case of native valve endocarditis [31][32][33][34].…”

Mycobacterium Abscessus Native Tricuspid Valve Endocarditis. Is a Six-Week Course of Combination Antibiotic Therapy Enough?

“…Use of IV drugs as a risk factor of M abscessus endocarditis was documented by (Tsai et al 2008;Garcia et al, 2014) and Huth et al (2015). The presence of central or peripherally inserted catheters, hemodialysis catheters and coronary angiogram have also been described as the predisposing factors by others (Rodge et al, 2017;Williamson et al, 2009;Al-Benwan et al, 2010). Tricuspid and mitral valve involvement have been reported more often than the aortic valve.…”

“…M. abscessus most commonly infects the skin and soft tissues or lungs. Although mycobacterial endocarditis is rare, it should be considered in a differential diagnosis when evaluating a septic patient with prosthetic cardiac devices, trauma, indwelling vascular access, a history of intravenous drug use, recent surgical procedures, or immunocompromised status (Huth et al, 2015;Bush et al, 2011;Rodge et al, 2017). Approximately 5-10% of all IE cases are rightsided endocarditis.…”

“…Of those, about 90% involve the tricuspid valve (TV) and septic pulmonary emboli occur in about 5.7% of the patients (Song et al, 2016). TV endocarditis is strongly associated with intravenous drug use (Rodge et al, 2017). Infective endocarditis (IE) of the native heart valves due to M abscessus has been reported in persons who inject drugs (PWID) and in persons with central venous catheters (Hussain et al, 2017;Liebeskind et al, 2001).…”