title: Mycobacterium branderi infection: Case report and literature review of an unusual and difficult-to-treat non-tuberculous mycobacterium.
abstract: A 67-year-old man with significant smoking history presented with fever, unintentional weight loss, night sweats, productive cough, and progressive dyspnea. Multiple respiratory specimens grew Mycobacterium branderi. Computed tomography scanning of the chest revealed a cavitary right upper lung lesion. Bronchoscopy and thoracoscopic biopsy were negative for malignancy but showed necrotizing granulomatous inflammation, which was culture negative. Due to clinical and radiologic progression despite therapy with clarithromycin, ethambutol and moxifloxacin, the lesion was surgically resected and the patient's symptoms resolved. Mycobacteria were seen in histopathology but did not grow from resected tissue. The patient received an additional 6 months of medical therapy and remains asymptomatic 1 month after completing antimicrobials. Cases of M. branderi causing human infection are very rarely reported. This is a novel case of multi-drug resistant M. branderi pulmonary infection in an apparently immunocompetent patient, progressive despite medical therapy and requiring surgical resection for definitive management.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. Electronic address: sturvey@ualberta.ca.
authors.forename: Shannon L
authors.initials: SL
authors.lastname: Turvey
authors.affiliation: The Division of Diagnostic and Applied Microbiology, Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada; The Provincial Laboratory for Public Health (Microbiology), Edmonton, Alberta, Canada. Electronic address: Greg.Tyrrell@albertahealthservices.ca.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Tyrrell
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. Electronic address: chernand@ualberta.ca.
authors.forename: Cristina
authors.initials: C
authors.lastname: Hernandez
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. Electronic address: dkabbani@ualberta.ca.
authors.forename: Dima
authors.initials: D
authors.lastname: Kabbani
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. Electronic address: karen.doucette@ualberta.ca.
authors.forename: Karen
authors.initials: K
authors.lastname: Doucette
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. Electronic address: cerveraa@ualberta.ca.
authors.forename: Carlos
authors.initials: C
authors.lastname: Cervera
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001999:Bronchoscopy; D017291:Clarithromycin / Q000627:therapeutic use; D004977:Ethambutol / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009161:Mycobacterium; D009165:Mycobacterium Infections, Nontuberculous / Q000188:drug therapy / Q000382:microbiology*; D009170:Nontuberculous Mycobacteria; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents; D004977:Ethambutol; D017291:Clarithromycin
keywords: Mycobacterium branderi; Non-tuberculous mycobacteria; multi-drug resistant mycobacteria