Fatal pulmonary infection due to multidrug-resistant Mycobacterium abscessus in a patient with cystic fibrosis.
We report a case of fatal pulmonary infection caused by Mycobacterium abscessus in a young patient with cystic fibrosis, who underwent bipulmonary transplantation after a 1-year history of severe lung disease. Fifteen days after surgery he developed septic fever with progressive deterioration in lung function. M. abscessus, initially isolated from a pleural fluid specimen, was then recovered from repeated blood samples, suggesting a disseminated nature of the mycobacterial disease. Drug susceptibility testing assay, performed on two sequential isolates of the microorganism, showed a pattern of multidrug resistance. Despite aggressive therapy with several antimycobacterial drugs, including clarithromycin, the infection persisted, and the patient died.
Sanguinetti
M
M
Istituto di Microbiologia, Università Cattolica del S. Cuore, Ospedale Pediatrico Bambino Gesù, Rome, Italy. msanguinetti@rm.unicatt.it
Ardito
F
F
Fiscarelli
E
E
La Sorda
M
M
D'Argenio
P
P
Ricciotti
G
G
Fadda
G
G
D000328:Adult; D000900:Anti-Bacterial Agents; D003550:Cystic Fibrosis / Q000601:surgery*; D018432:Drug Resistance, Multiple; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D017809:Fatal Outcome; D006801:Humans; D008171:Lung Diseases / Q000188:drug therapy / Q000382:microbiology*; D016040:Lung Transplantation; D008297:Male; D008826:Microbial Sensitivity Tests; D009161:Mycobacterium / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D009164:Mycobacterium Infections / Q000175:diagnosis / Q000188:drug therapy*; D011183:Postoperative Complications / Q000382:microbiology*
D000900:Anti-Bacterial Agents