Mycobacterium chelonae necrotizing pneumonia after allogeneic hematopoietic stem cell transplant: report of clinical response to treatment with tigecycline.
We present a case of progressive Mycobacterium chelonae ssp. chelonae necrotizing pneumonia after hematopoietic stem cell transplantation (HSCT) in the presence of chronic graft-versus-host disease. The patient failed to respond to standard combination therapy with multiple agents and developed resistance to most drugs over the course of treatment. Tigecycline, a new glycylcycline antimicrobial agent with in vitro activity against M. chelonae, was then used with a clinical response to treatment. To our knowledge, this is the first reported case demonstrating tigecycline to have a degree of clinical effectiveness to treat refractory pulmonary infection with M. chelonae in an HSCT recipient.
Peres
E
E
Blood and Marrow Transplant Program, University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan 48109-5941, USA. edwardpe@umich.edu
Khaled
Y
Y
Krijanovski
O I
OI
Mineishi
S
S
Levine
J E
JE
Kaul
D R
DR
Riddell
J
J
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008911:Minocycline / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009165:Mycobacterium Infections, Nontuberculous / Q000188:drug therapy / Q000382:microbiology; D016926:Mycobacterium chelonae / Q000187:drug effects*; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D000078304:Tigecycline; D014182:Transplantation, Autologous / Q000009:adverse effects*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000078304:Tigecycline; D008911:Minocycline