title: Catheter-related Mycobacterium abscessus bacteremia manifested with skin nodules, pneumonia, and mediastinal lymphadenopathy.
abstract: Although previously rare, catheter-related bloodstream infection caused by rapidly growing mycobacteria is now increasingly encountered, especially among cancer patients who have catheters implanted for chemotherapy treatments. A 73-year-old female patient with acute myeloid leukemia (AML) had Mycobacterium abscessus bacteremia with manifestations of multiple skin nodules, pneumonia, and mediastinal lymphadenopathy 4 months after the implantation of a peripherally inserted central catheter (PICC) for the delivery of chemotherapy. The catheter-related M. abscessus bacteremia was confirmed by positive blood cultures of specimens drawn from a PICC line and a peripheral vein. She defervesced with the administration of meropenem, amikacin, levofloxacin, clarithromycin, and by the removal of PICC. Her fever subsided for 3 months with the disappearance of skin and lung lesions; however, she died of AML relapse. Bacteremia and skin infection caused by M. abscessus can be detected by culture and pathological examinations and should be considered in leukemia patients with a PICC. With appropriate laboratory diagnosis, M. abscessus bacteremia with disseminated infections can improve with catheter removal and combination antimicrobial therapy.
authors.affiliation: Department of Internal Medicine, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan.
authors.forename: Shou-Hsin
authors.initials: SH
authors.lastname: Su
authors.forename: Yen-Hsu
authors.initials: YH
authors.lastname: Chen
authors.forename: Tung-Yuan
authors.initials: TY
authors.lastname: Tsai
authors.forename: Su-Chiao
authors.initials: SC
authors.lastname: Huang
authors.forename: Chun-Yu
authors.initials: CY
authors.lastname: Lin
authors.forename: Tun-Chieh
authors.initials: TC
authors.lastname: Chen
authors.forename: Po-Liang
authors.initials: PL
authors.lastname: Lu
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D055499:Catheter-Related Infections / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D002405:Catheterization, Central Venous; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy; D008206:Lymphatic Diseases / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D008482:Mediastinum; D009165:Mycobacterium Infections, Nontuberculous / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D009170:Nontuberculous Mycobacteria; D018410:Pneumonia, Bacterial / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D012867:Skin / Q000382:microbiology / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents