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Mycobacterium fortuitum infection of a hemodialysis catheter in a pediatric patient
Author(s) -
Morgans Heather A.,
Mallett Kathleen F.,
Sebestyen Vansickle Judith F.,
Warady Bradley A.
Publication year - 2019
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/hdi.12731
Subject(s) - medicine , mycobacterium fortuitum , hemodialysis , catheter , peritoneal dialysis , dialysis , surgery , antibiotics , lesion , mycobacterium , tuberculosis , pathology , microbiology and biotechnology , biology
This case report discusses a pediatric patient who developed a hemodialysis catheter line infection from an uncommon etiology, Mycobacterium fortuitum . The initial presentation revealed a well appearing patient with a slow growing skin lesion near the site of the hemodialysis catheter. The treatment course was complicated by resistance to initial antibiotics leading to continued spread of the lesion. The diagnosis was confirmed via skin biopsy of the lesion that required 2 weeks to grow the atypical Mycobacterium. Treatment was successful after hemodialysis catheter removal, transition to peritoneal dialysis, and a prolonged antibiotic course. Mycobacterium fortuitum is a rare cause of dialysis catheter infections that is resistant to standard antibiotic treatment. Treatment success is improved after removal of the dialysis catheter and prolonged antibiotics based on susceptibilities. This case highlights the importance of keeping atypical Mycobacterium in the differential for patients with slow growing skin lesions near dialysis catheter sites with resistance to initial treatment.