title: Osteomyelitis due to Mycobacterium haemophilum in a cardiac transplant patient: case report and analysis of interactions among clarithromycin, rifampin, and cyclosporine.
abstract: We describe a case of osteomyelitis due to Mycobacterium haemophilum in a cardiac transplant recipient and review the two other reported cases of M. haemophilum infection in cardiac transplant patients. Our patient had an excellent response to a prolonged course of therapy with clarithromycin and rifampin. We examine in detail the interactions between these two antibiotics and cyclosporine, including the apparently offsetting effects of clarithromycin/rifampin combination therapy on blood levels of cyclosporine.
authors.affiliation: Infectious Disease Service, Brooke Army Medical Center, Fort Sam Houston, Texas 78234, USA.
authors.forename: R M
authors.initials: RM
authors.lastname: Plemmons
authors.forename: C K
authors.initials: CK
authors.lastname: McAllister
authors.forename: M C
authors.initials: MC
authors.lastname: Garces
authors.forename: R L
authors.initials: RL
authors.lastname: Ward
mesh_terms: D000328:Adult; D017291:Clarithromycin / Q000008:administration & dosage*; D016572:Cyclosporine / Q000008:administration & dosage* / Q000097:blood / Q000187:drug effects; D004347:Drug Interactions; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D016027:Heart Transplantation / Q000009:adverse effects* / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D009164:Mycobacterium Infections / Q000188:drug therapy* / Q000209:etiology; D018393:Mycobacterium haemophilum / Q000187:drug effects / Q000302:isolation & purification; D010019:Osteomyelitis / Q000188:drug therapy* / Q000276:immunology / Q000382:microbiology; D012293:Rifampin / Q000008:administration & dosage*
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D017291:Clarithromycin; D012293:Rifampin