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Background Mycobacterium massiliense  is a rapidly growing a non-tuberculous mycobacterium that has been validated as a separate species from the  Mycobacterium abscessus  group. Only few antibiotics have demonstrated germicidal activity against  Mycobacterium massiliense , and some of those include amikacin, clarithromycin, and cefoxitin. Case presentation We present the first reported case of near-fatal septic shock caused by disseminated  Mycobacterium massiliense  after de-clotting of an infected arteriovenous fistula, in a patient with end-stage renal disease with concomitant human immunodeficiency virus infection. Early recognition of the culprit organism and treatment with a combination therapy of clarithromycin and amikacin led to rapid improvement. Conclusion This unique case can highlight the importance of taking into consideration  Mycobacterium massiliense  infection as a cause of arteriovenous fistula thrombosis and highlights the risk of disseminated infection leading to life threatening sepsis upon de-clotting of the fistula.

Case report of a near-fatal case of Mycobacterium massiliense sepsis after de-clotting of an arteriovenous fistula