Mycobacterium fortuitum and Polymicrobial Peritoneal Dialysis-Related Peritonitis: A Case Report and Review of the Literature

How can we improve the outcome for transplant patients with nontuberculous mycobacterial infections?

Nontuberculous mycobacteria (NTM) are environmental organisms that are rapidly emerging as pathogens in the transplant population. The prevalence of infection in transplant recipients remains unknown. While guidelines exist for treatment of NTM, neither the American Thoracic Society, the Infectious Diseases Society of America, nor the British Thoracic Society guidelines dictate the approach needed for transplant recipients. Here, we summarize risk factors, important diagnostic and treatment facts, and preventive measures to be taken to help improve outcomes of those infected with NTM infections.

Mycobacterium wolinskyi Peritonitis after Peritoneal Catheter Embedment Surgery

Mycobacterium wolinskyi belongs to the Mycobacterium smegmatis group, which comprises rapidly growing non-tuberculous mycobacteria. The number of case reports on M. wolinskyi infections associated with postoperative wounds has increased in recent years. We herein report a case of peritonitis due to M. wolinskyi after peritoneal catheter embedment surgery. Identification was achieved based on 16S ribosomal RNA and rpoB gene sequencing of the isolate. The patient recovered following catheter removal and treatment with levofloxacin and minocycline for one month.

Septicemia and pneumonia due to Mycobacterium fortuitum infection in a patient with extronodal NK/T-cell lymphoma, nasal type: A case report

RATIONALE

Mycobacterium fortuitum (M.fortuitum) is one of the rapidly growing nontuberculous mycobacterium (NTM) that is widespread in the environment. M.fortuitum can cause different types of disease including pulmonary disease, lymphadenitis, cutaneous disease, and disseminated disease. However, the infection presenting as septicemia is exceedingly rare.

PATIENT CONCERNS

A 48-year-old immunocompromised male with extranodal NK/T-cell lymphoma, nasal type was admitted to the hospital because of high fever for 10 days.

DIAGNOSES

The pathogen identified twice in the hemoculture was M.fortuitum, but not in the sputum culture. The chest computed tomographic (CT) scan showed a chronic inflammatory infection.

INTERVENTIONS

The patient was treated with sulfamethoxazole and levofloxacin.

OUTCOMES

The symptom of patient disappeared after the treatment for one week, and near-total absorption of the consolidation in CT after the treatment for one month. He continued the treatment for one year until the last negative hemoculture.

LESSONS

Although the M.fortuitum infection presenting as septicemia is rare, a high suspicion of M.fortuitum is required, particularly in the immunosuppressive patients. Timely and adequate treatment is necessary.