Open AccessCompromised longevity due to Mycobacterium abscessus pulmonary disease in lungs scarred by tuberculosis
Author(s) -
Urvashi Singh,
Rojaleen Das,
Prajowl Shrestha,
Kiran Bala,
Pooja Pandey,
Santosh Kumar Verma,
Hitender Gautam,
Elizabeth Story-Roller,
Gyanu Lamichhane,
Randeep Guleria
Publication year - 2019
Publication title -
access microbiology
Language(s) - English
Resource type - Journals
ISSN - 2516-8290
DOI - 10.1099/acmi.0.000003
Subject(s) - mycobacterium abscessus , medicine , ethambutol , nontuberculous mycobacteria , clarithromycin , linezolid , azithromycin , antibiotics , exacerbation , regimen , tuberculosis , amikacin , sputum culture , intensive care medicine , mycobacterium tuberculosis , sputum , mycobacterium , pathology , microbiology and biotechnology , vancomycin , biology , bacteria , genetics , helicobacter pylori , staphylococcus aureus
Structural lung diseases or scarring related to prior infections such as tuberculosis (TB) are risk factors for the development of invasive nontuberculous mycobacterial (NTM) pulmonary infections, such asMycobacterium abscessus . M. abscessusis intrinsically resistant to many antibiotics and in vitro susceptibility correlates poorly with clinical response, especially in pulmonary disease. Treatment is often difcult due to the lack of effective antibiotic regimens. We present a case of a 56-year-old male previously treated for TB, with presumed exacerbation, who was diagnosed after much delay with pulmonaryM. abscessusdisease and subsequently failed initial treatment with an empirical antibiotic regimen. When placed on a synergistic combination regimen that included amikacin, linezolid, clarithromycin, ethambutol and faropenem, the patient showed a favourable response and was culture-negative for over 12 months when the treatment was stopped as per American Thoracic Society (ATS) recommendations. Unfortunately, he developed recurrent symptoms and died 9 months after stopping treatment, following an acute exacerbation of fever and respiratory failure.