title: Disseminated mycobacteriosis affecting a prosthetic aortic valve: first case of Mycobacterium peregrinum type III reported in Colombia.
abstract: Rapidly growing mycobacteria are non-tuberculous mycobacteria amply present in the environment. Although they are not usually pathogenic for humans, they are opportunistic in that they can cause disease in people with disadvantageous conditions or who are immunocompromised. Mycobacterium peregrinum, an opportunistic, rapidly growing mycobacteria, belongs to the M. fortuitum group and has been reported as responsible for human cases of mycobacteriosis. A case of M. peregrinum type III is herein reported as the first in Colombia. It presented as a disseminated disease involving a prosthetic aortic valve (endocarditis) in a seventeen-year-old girl with a well-established diagnosis of prosthetic aortic valve endocarditis who was referred for a surgical replacement. Due to a congenital heart disease (subaortic stenosis with valve insufficiency), she had two previous aortic valve implantation surgeries. One year after the second implantation, the patient presented with respiratory symptoms and weight lost indicative of lung tuberculosis. A chest X-ray did not show parenchymal compromise but several Ziehl-Neelsen stains were positive. An echocardiography showed a vegetation on the prosthetic aortic valve. In blood and sputum samples, M. peregrinum type III was identified through culture, biochemical tests and hsp65 gene molecular analysis (PRA). The patient underwent a valve replacement and received a multidrug antimycobacterial treatment. Progressive recovery ensued and further samples from respiratory tract and blood were negative for mycobacteria.
authors.affiliation: Departamentos de Investigación y Médico, Fundación Neumológica Colombiana, Bogotá, DC, Colombia.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Torres-Duque
authors.forename: Claudia
authors.initials: C
authors.lastname: Díaz
authors.forename: Leslie
authors.initials: L
authors.lastname: Vargas
authors.forename: Elsa María
authors.initials: EM
authors.lastname: Serpa
authors.forename: Walter
authors.initials: W
authors.lastname: Mosquera
authors.forename: María Consuelo
authors.initials: MC
authors.lastname: Garzón
authors.forename: Graciela
authors.initials: G
authors.lastname: Mejía
authors.forename: Luz Mary
authors.initials: LM
authors.lastname: García
authors.forename: Liliana Andrea
authors.initials: LA
authors.lastname: González
authors.forename: Claudia Marcela
authors.initials: CM
authors.lastname: Castro
authors.forename: Wellman
authors.initials: W
authors.lastname: Ribón
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001021:Aortic Valve / Q000601:surgery; D003105:Colombia; D004696:Endocarditis / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery*; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000382:microbiology*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D009161:Mycobacterium / Q000472:pathogenicity*; D009164:Mycobacterium Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery*
chemical_list: D000900:Anti-Bacterial Agents