title: Tsukamurella tyrosinosolvensbacteremia with coinfection ofMycobacterium bovispneumonia: case report and literature review.
abstract: BACKGROUND
  We describe an immunocompromised patient withTsukamurella tyrosinosolvensbacteremia and coinfection ofMycobacterium bovispneumonia.
  
  
  METHODS
  A 75-year-old male was admitted to our hospital complaining of persistent fever with general malaise. His medical history showed that he had diabetes mellitus (HbA1C 9.2%). A chest computed tomography (CT) showed left upper lung consolidation . Two sets of blood culture at admission finally showedTsukamurella tyrosinosolvens. Moreover, three transbronchoscopy washing specimen cultures revealedMycobacterium bovis.
  
  
  RESULTS
  The organismTsukamurella tyrosinosolvenswas identified using conventional biochemical identification methods, PCR-restriction DNA fragment analysis, and 16S rRNA gene sequencing. The clinical mycobacterial isolates were identified to the species level by combining Polymerase Chain Reaction (PCR) with an oligonucleotide microarray to detect theM. bovisamplicons.
  
  
  CONCLUSIONS
  According to our literature review, our patient's case was the first of a coinfection withTsukamurella tyrosinosolvensandMycobacterium bovis. Prolonged antibiotic treatment and underlying disease control are necessary for this type of patient.
authors.affiliation: Department of Internal Medicine, Chest Division, Tainan Municipal Hospital, Tainan, Taiwan.
authors.forename: Chang-Hung
authors.initials: CH
authors.lastname: Chen
authors.affiliation: Department of Clinical Laboratory, Tainan Municipal Hospital, Tainan, Taiwan.
authors.forename: Chao-Tai
authors.initials: CT
authors.lastname: Lee
authors.affiliation: Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Tsung-Chain
authors.initials: TC
authors.lastname: Chang
keywords: Bacteremia; PCR (polymerase chain reaction); Pneumonia; rRNA (ribosome RNA)