Mycobacterium marseillense bloodstream infection combined with skin fungal infection: a case report and literature review.
Humans
Male
Middle Aged
Mycobacterium Infections, Nontuberculous
/ microbiology
Dermatomycoses
/ microbiology
Kidney Transplantation
/ adverse effects
Immunocompromised Host
Anti-Bacterial Agents
/ therapeutic use
Nontuberculous Mycobacteria
/ isolation & purification
Bacteremia
/ microbiology
Mycobacterium
/ isolation & purification
Skin
/ microbiology
Mycobacterium marseillense
Bloodstream infection
Non-tuberculous mycobacterium
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
22 Aug 2024
22 Aug 2024
Historique:
received:
04
02
2024
accepted:
08
08
2024
medline:
23
8
2024
pubmed:
23
8
2024
entrez:
22
8
2024
Statut:
epublish
Résumé
Non-tuberculous mycobacteria (NTM) are present widely in the natural environment and can invade the human body through the respiratory tract, gastrointestinal tract, and skin. Immunocompromised patients are particularly prone to infection, which primarily affects multiple organs, including the lungs, lymph nodes, and skin. However, cases of NTM bloodstream infections are rare. Here, we report a rare case of Mycobacterium marseillense bloodstream infection with concurrent skin fungal infection in a patient after kidney transplantation. Related literature was reviewed to enhance the understanding of this rare condition. A 58-year-old male with a history of long-term steroid and immunosuppressant use after kidney transplantation presented with limb swelling that worsened over the past two months. Physical examination revealed redness and swelling of the skin in all four limbs, with a non-healing wound on the lower left limb. Skin tissue analysis by metagenomic next-generation sequencing (mNGS) and fungal culture indicated infection with Trichophyton rubrum. Blood culture results suggested infection with Mycobacterium marseillense. After receiving anti-NTM treatment, the patient's symptoms significantly improved, and he is currently undergoing treatment. Mycobacterium marseillense is a NTM. Gram staining suffered from misdetection, and the acid-fast staining result was positive. This bacterium was identified by mass spectrometry and mNGS analyses. Antimicrobial susceptibility tests for NTM were performed using the broth microdilution method. The results of the susceptibility test showed that Mycobacterium marseillense was sensitive to clarithromycin, an intermediary between moxifloxacin and linezolid. Bacterial clearance requires a combination of drugs and an adequate course of treatment. NTM bloodstream infections are relatively rare, and early identification and proactive intervention are key to their successful management.
Sections du résumé
BACKGROUND
BACKGROUND
Non-tuberculous mycobacteria (NTM) are present widely in the natural environment and can invade the human body through the respiratory tract, gastrointestinal tract, and skin. Immunocompromised patients are particularly prone to infection, which primarily affects multiple organs, including the lungs, lymph nodes, and skin. However, cases of NTM bloodstream infections are rare. Here, we report a rare case of Mycobacterium marseillense bloodstream infection with concurrent skin fungal infection in a patient after kidney transplantation. Related literature was reviewed to enhance the understanding of this rare condition.
CASE PRESENTATION
METHODS
A 58-year-old male with a history of long-term steroid and immunosuppressant use after kidney transplantation presented with limb swelling that worsened over the past two months. Physical examination revealed redness and swelling of the skin in all four limbs, with a non-healing wound on the lower left limb. Skin tissue analysis by metagenomic next-generation sequencing (mNGS) and fungal culture indicated infection with Trichophyton rubrum. Blood culture results suggested infection with Mycobacterium marseillense. After receiving anti-NTM treatment, the patient's symptoms significantly improved, and he is currently undergoing treatment.
CONCLUSION
CONCLUSIONS
Mycobacterium marseillense is a NTM. Gram staining suffered from misdetection, and the acid-fast staining result was positive. This bacterium was identified by mass spectrometry and mNGS analyses. Antimicrobial susceptibility tests for NTM were performed using the broth microdilution method. The results of the susceptibility test showed that Mycobacterium marseillense was sensitive to clarithromycin, an intermediary between moxifloxacin and linezolid. Bacterial clearance requires a combination of drugs and an adequate course of treatment. NTM bloodstream infections are relatively rare, and early identification and proactive intervention are key to their successful management.
Identifiants
pubmed: 39174918
doi: 10.1186/s12879-024-09741-y
pii: 10.1186/s12879-024-09741-y
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Case Reports
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
853Informations de copyright
© 2024. The Author(s).
Références
Sharma SK, Upadhyay V. Epidemiology, diagnosis & treatment of non-tuberculous mycobacterial d iseases. Indian J Med Res. 2020;152(3):185–226.
doi: 10.4103/ijmr.IJMR_902_20
pubmed: 33107481
pmcid: 7881820
Schoenfeld N, Haas W, Richter E, Bauer T, Boes L, Castell S, Hauer B, Magdorf K, Matthiessen W, Mauch H, Reuss A, Schenkel K, Ruesch-Gerdes S, Zabel P, Dalhoff K, Schaberg T, Loddenkemper R. Recommendations of the German Central Committee against Tuberculosis (DZK) and the German respiratory society (DGP) for the diagnosis and tr eatment of non-tuberculous mycobacterioses. Pneumologie. 2016;70(4):250–76.
doi: 10.1055/s-0041-111494
pubmed: 27064418
Bian S-N, Zhang L-F, Zhang Y-Q, Yang Q-W, Wang P, Xu Y-C, Shi X-C, Liu X-Q. Clinical and Laboratory characteristics of patients with Nontuberculou s Mycobacterium Bloodstream Infection in a Tertiary Referral Hospital in Beijing, China. Chin Med J. 2016;129(18):2220–5.
doi: 10.4103/0366-6999.189920
pubmed: 27625095
pmcid: 5022344
Pérez-Cortés Villalobos A, Rotstein C. ) < i > Mycobacterium mucogenicum and < i > Mycobacterium neoaurum bac teremia in immunocompromised hosts. J Assoc Med Microbiol Infect Dis Can. 2021;6(1):55–62.
pubmed: 36340214
pmcid: 9612434
Miao Q, Ma Y, Wang Q, Pan J, Zhang Y, Jin W, Yao Y, Su Y, Huang Y, Wang M, Li B, Li H, Zhou C, Li C, Ye M, Xu X, Li Y, Hu B. Microbiological Diagnostic performance of Metagenomic Next-generation sequencing when Applied to Clinical Practice. Clin Infect Diseases: Official Publication Infectio us Dis Soc Am. 2018;67(suppl2):S231–40.
doi: 10.1093/cid/ciy693
Naito M, Fukushima K, Kusakabe S, Endo T, Shiroyama T, Ohira K, Azuma K, Tanizaki S, Yamamoto Y, Hosono Y, Naito Y, Futami S, Miyake K, Hirata H, Takeda Y, Kumanogoh A. Disseminated non-tuberculous mycobacterial infection caused by Mycobac terium obuense in an immunocompromised patient: a case report. BMC Infect Dis. 2023;23(1):517.
doi: 10.1186/s12879-023-08510-7
pubmed: 37550642
pmcid: 10408174
Abad CL, Razonable RR. Non-tuberculous mycobacterial infections in solid organ transplant rec ipients: an update. J Clin Tuberc Other Mycobact Dis. 2016;4:1–8.
doi: 10.1016/j.jctube.2016.04.001
pubmed: 31723683
pmcid: 6850244
Haverkamp MH, van Dissel JT, Holland SM. Human host genetic factors in nontuberculous mycobacterial infection: lessons from single gene disorders affecting innate and adaptive immun ity and lessons from molecular defects in interferon-gamma-dependent s ignaling. Microbes Infect. 2006;8(4):1157–66.
doi: 10.1016/j.micinf.2005.10.029
pubmed: 16520075
Dorman S, Subramanian A, Practice ASTIDC. (2009) Nontuberculous mycobacteria in solid organ transplant recipients. American journal of transplantation: official journal of the American Society of Transplantation and the American Society of Transplant Sur geons 9 Suppl 4:S63-69.
Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F, Holland SM, Horsburgh R, Huitt G, Iademarco MF, Iseman M, Olivier K, Ruoss S, von Reyn CF, Wallace RJ Jr., Winthrop K, Subcommittee ATSMD, American Thoracic S, Infectious Disease Society of A. An official ATS/IDSA statement: diagnosis, treatment, and prevention o f nontuberculous mycobacterial diseases. Am J Respir Crit Care Med. 2007;175(4):367–416.
doi: 10.1164/rccm.200604-571ST
pubmed: 17277290
Rodge G, Nagvekar V, Jhala D, George A. Mycobacterium abscessus causing native valve endocarditis due to perip herally inserted central catheter line. J Clin Tuberc Other Mycobact Dis. 2017;9:19–20.
doi: 10.1016/j.jctube.2017.09.001
pubmed: 31723712
pmcid: 6850255
Samaddar A, Srivastava S, Khan S, Tak V, Sharma A, Nag VL, Bohra GK. ) < i > Mycobacterium chelonae bacteraemia in a patient with myasthenia gravis receiving long-term steroid therapy. Access Microbiol. 2019;1(10):e000069.
doi: 10.1099/acmi.0.000069
pubmed: 32974503
pmcid: 7491934
Ueda Y, Tokumasu K, Hagiya H, Iio K, Fujimori T, Kakehi A, Okura M, Minabe H, Otsuka F. Mycobacterium chelonae bloodstream infection induced by osteomyelitis of toe: a case report. J Infect Chemotherapy: Official J Japan Soc Chemother. 2020;26(8):843–6.
doi: 10.1016/j.jiac.2020.03.004
Grandjean Lapierre S, Toro A, Drancourt M. Mycobacterium Iranicum bacteremia and hemophagocytic lymphohistiocytos is: a case report. BMC Res Notes. 2017;10(1):372.
doi: 10.1186/s13104-017-2684-8
pubmed: 28789664
pmcid: 5549388
Furukawa Y, Hamada H, Kamikawaji K, Unoki T, Inoue H, Tashiro Y, Okamoto M, Baba M, Hashiguchi T. Successful treatment of an AIDS patient with prolonged Mycobacterium a vium bacteremia, high HIV RNA, HBV infection, Kaposi’s sarcoma and cyt omegalovirus retinitis. J Infect Chemotherapy: Official J Japan Soc Chemother. 2020;26(2):279–81.
doi: 10.1016/j.jiac.2019.08.012
Watanabe Y, Fujita H, Fukushima S, Nakamura I. Disseminated Mycobacterium chelonae infection, including Discitis. Intern Med. 2022;61(13):2085–6.
doi: 10.2169/internalmedicine.8539-21
pubmed: 34924460
Zeitler K, Walter J, Khan F, Sriaroon C. Recurrent disseminated < i > Mycobacterium avium in a female patient from Thailand with anti-interferon-gamma autoantibodies: dilemma on Tr eatment approach. BMJ Case Rep. 2021;14(1):e237909.
doi: 10.1136/bcr-2020-237909
pubmed: 33509870
pmcid: 7845683
Yamada T, Iwakami S-I, Hara SAM, Iwakami N, Nakamura A, Suzuki Y, Sasaki S-I, Takahashi K. Disseminated non-tuberculous mycobacterial infection caused by anti-in terferon-γ autoantibodies in a patient of very advanced age. Geriatr Gerontol Int. 2018;18(7):1132–3.
doi: 10.1111/ggi.13313
pubmed: 30133967
Shabi Y, Haldane D, Bonnar P. ) < i > Mycobacterium fortuitum pacemaker infection: a case report. J Assoc Med Microbiol Infect Dis Can. 2022;7(1):81–3.
pubmed: 36340848
pmcid: 9603015
Walayat S, Awwal T, Roy M, Ahmad S. ) < i > Mycobacterium neoaurum line-related bacteremia with pulmonary i nvolvement: Case report and review of literature. IDCases. 2018;11:88–90.
doi: 10.1016/j.idcr.2018.01.004
pubmed: 29552489
pmcid: 5849790
Butt S, Tirmizi A. ) < i > Mycobacterium smegmatis bacteremia in an immunocompetent host. IDCases. 2019;15:e00523.
doi: 10.1016/j.idcr.2019.e00523
pubmed: 30937286
pmcid: 6430072
Nagata A, Sekiya N, Najima Y, Horiuchi M, Fukushima K, Toya T, Igarashi A, Kobayashi T, Kakihana K, Ohashi K, Doki N. Nontuberculous mycobacterial bloodstream infections after allogeneic h ematopoietic stem cell transplantation. Int J Infect Diseases: IJID: Official Publica tion Int Soc Infect Dis. 2020;97:131–4.
Shaharir SS, Sulaiman Sahari N, Mohamed Fuad Z, Zukiman WZHW, Mohd Yusof NH, Sulong A, Periasamy P. Non-tuberculous mycobacterium bacteraemia in a pregnant systemic lupus erythematosus (SLE) patient: a case review and pooled case analysis. Clin Rheumatol. 2018;37(3):837–47.
doi: 10.1007/s10067-017-3855-7
pubmed: 28971307
Takemori-Sakai Y, Iwata Y, Oe H, Sakai Y, Wada T. Bloodstream infection caused by Mycobacterium chelonae. Pediatr Int. 2018;60(6):599–600.
doi: 10.1111/ped.13553
pubmed: 29808614