Open AccessRecurrent bilateral breast abscess due to Mycobacterium abscessus in an immune-competent woman
Author(s) -
Kiran Bala,
Sanjana Kumari,
Randeep Guleria,
Urvashi Singh
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2020-235857
Subject(s) - medicine , levofloxacin , amikacin , mycobacterium abscessus , clarithromycin , surgery , antibiotics , rifabutin , abscess , debridement (dental) , mycobacterium , tuberculosis , pathology , microbiology and biotechnology , biology , helicobacter pylori
Mycobacterium abscessus is a rapidly growing, non-tubercular mycobacteria, often associated with skin and soft tissue infections. We report a case of 57-year-old immune-competent woman who suffered recurrent bilateral breast infection for 6 years. She did not benefit from repeated surgical interventions and multiple courses of antibiotics, and one course of empirical antitubercular therapy. Chronicity of the presentation and non-response to varied treatment interventions prompted further microbiological investigations. The patient was diagnosed with M. abscessus and treated with rifabutin, clarithromycin daily for 6 months and injection amikacin for 1 month. Amikacin was replaced with oral levofloxacin due to bilateral sensory-neural hearing loss for higher frequencies after 6 months. Suspicion and identification of NTM are important as the treatment involves long-term combination antibacterial therapy along with surgical debridement for extensive infection or when implants are involved.