title: Lung abscess due to non-tuberculous, non-Mycobacterium fortuitum in a neonate.
abstract: Although Mycobacterium fortuitum (MF) is a non-tuberculous mycobacterium that rarely causes disease, there are reported cases of pneumonia, lung abscess, and empyema in subjects with predisposing lung disease. We report a neonate, without predisposing disease or risk factors, who manifested pneumonia and lung abscess. The patient was initially treated with amoxicillin-clavulanic acid and gentamycin, and subsequently with piperazilin, tazobactam, and vancomycin when there was no improvement. Pleural nodules were detected on computed tomography, and microbiology revealed MF in the absence of other pathogens and a week later the organism was identified in culture as MF, confirmed on four separate samples. The MF was sensitive to amikacin and clarithromycin and the patient was continued on oral clarithromycin for two more weeks until full recovery. To our knowledge, this is the first reported case of MF abscess in a neonate. MF should be sought in similar patients, especially when microbiology fails to detect the usual pathogens, and when the clinical picture is unclear.
authors.affiliation: Division of Pediatric Emergency Medicine, Department of Pediatrics, Dana's Children Hospital, University of Tel-Aviv, Tel-Aviv, Israel. nopasara73@hotmail.com
authors.forename: Miguel
authors.initials: M
authors.lastname: Glatstein
authors.forename: Dennis
authors.initials: D
authors.lastname: Scolnik
authors.forename: Liat
authors.initials: L
authors.lastname: Bensira
authors.forename: Keren Armoni
authors.initials: KA
authors.lastname: Domany
authors.forename: Mansi
authors.initials: M
authors.lastname: Shah
authors.forename: Snehal
authors.initials: S
authors.lastname: Vala
mesh_terms: D000583:Amikacin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008169:Lung Abscess / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology*; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D019907:Mycobacterium fortuitum / Q000187:drug effects / Q000302:isolation & purification*; D011859:Radiography; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000583:Amikacin; D017291:Clarithromycin