Mycobacterium fortuitum misidentified as Corynebacterium jeikeium in catheter-related bloodstream infection

[Non-tuberculous mycobacterial infection of a totally implanted perfusion device]

INTRODUCTION

Catheter-related infection by non-tuberculous mycobacteria is rare but difficult to diagnose and the treatment is not standardized.

CASE REPORT

A 64-year-old woman treated for lung cancer with intravenous chemotherapy developed an infection of her totally implanted perfusion device with Mycobacterium chelonae. The infection was cured after surgical removal of the device and treatment with oral clarithromycin.

CONCLUSION

Mycobacteria may infect vascular access devices. Rapid diagnosis of such infections allows early treatment.

Misidentification of Mycobacterium fortuitum in an immunocompetent patient presenting with a unilateral neck mass

A 31-year-old African man with a blameless medical history presented with an enlarging neck swelling of 6 months duration. He was systemically well with normal heamatobiochemistry. MRI of the neck demonstrated abnormal signalling in the subcutaneous fat overlying the posterior spinal muscles in the midline and the left sternocleidomastoid muscle. Scanty growth of Rhodococcus equi was reported from a turbid fine needle aspirate of the neck on two separate occasions. The swelling progressed despite numerous antibiotic combinations which necessitated surgical debridement. Analysis of debrided tissue using 16S rDNA surprisingly identified Mycobacterium fortuitum, not R equi, thereby resolving our diagnostic conundrum.