title: Successful treatment of pulmonary Mycobacterium xenopi infection in a natural killer cell-deficient patient with clarithromycin, rifabutin, and sparfloxacin.
abstract: Isolation of Mycobacterium xenopi from the respiratory tract may indicate pneumonia, often clinically indistinguishable from tuberculosis. Resistance to the classic antituberculous drugs renders the treatment of these infections problematic. We report on a case of cavernous pneumonia caused by M. xenopi in a 36-year-old male with natural killer cell deficiency but without severe immunodeficiency. He was successfully treated with a novel triple-drug combination comprising clarithromycin, sparfloxacin, and rifabutin. An impressive subsequent regression of pathological pulmonary changes was observed, and mycobacteria could no longer be detected. The therapeutic potential of clarithromycin and sparfloxacin in the treatment of M. xenopi infections is discussed.
authors.affiliation: Department of Internal Medicine II, and Institute of Medical Immunology, University Hospital Rheinisch-Westfälische, Technische Hochschule Aachen, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Schmitt
authors.forename: N
authors.initials: N
authors.lastname: Schnitzler
authors.forename: J
authors.initials: J
authors.lastname: Riehl
authors.forename: G
authors.initials: G
authors.lastname: Adam
authors.forename: H G
authors.initials: HG
authors.lastname: Sieberth
authors.forename: G
authors.initials: G
authors.lastname: Haase
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use*; D017291:Clarithromycin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D024841:Fluoroquinolones; D006801:Humans; D007694:Killer Cells, Natural / Q000276:immunology*; D008168:Lung / Q000473:pathology; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D019912:Mycobacterium xenopi / Q000302:isolation & purification; D017828:Rifabutin / Q000627:therapeutic use*; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D000904:Antibiotics, Antitubercular; D000995:Antitubercular Agents; D024841:Fluoroquinolones; D017828:Rifabutin; D017291:Clarithromycin; C061363:sparfloxacin