scholarly journals Disseminated Mycobacterium avium Complex Infection Causing Multiple Skull Defects in an Immunocompetent Patient: A Case Report

2021 ◽  
Vol 17 (3) ◽  
pp. 202-206
Author(s):  
Jun Ho Choi ◽  
Seong Jin Oh ◽  
Jae Ha Hwang ◽  
Kwang Seog Kim ◽  
Sam Yong Lee
Keyword(s):  
Mycobacterium Avium ◽  
Mycobacterium Avium Complex ◽  
Chronic Wounds ◽  
Early Stage ◽  
Wound Care ◽  
Immunocompetent Patient ◽  
Prolonged Treatment ◽  
Skull Defects ◽  
Brain Infection

Mycobacterium avium complex (MAC) infection mainly causes pulmonary disease. However, in 20% to 30% of cases, it also induces various extrapulmonary diseases. Disseminated MAC infection occasionally occurs in immunocompromised patients but very rarely in immunocompetent patients. An 80-year-old immunocompetent woman presented with multiple chronic wounds on the scalp that had not improved despite prolonged treatment. A scalp abscess caused by disseminated MAC infection 4 years ago had gone through repeated cycles of improvement and aggravation despite continued use of anti-mycobacterial agents and active wound care. Enhanced brain computed tomography and magnetic resonance imaging revealed multiple skull defects and abscesses invading the dura mater. Under general anesthesia, the infected scalp skin and bone were sufficiently removed, and the bone and soft tissue defects were repaired with cranioplasty using a titanium mesh plate and local flap. As exemplified in this case, multiple chronic wounds unresponsive to treatment need to be screened for MAC infection. As chronic MAC infection in the scalp can cause skull destruction and brain infection, it needs to be treated aggressively at an early stage to prevent serious morbidity and mortality. Effective MAC infection management involves adequate medication, regular follow-up imaging, and active surgical procedure.

scholarly journals Characteristics of pulmonary Mycobacterium avium complex disease diagnosed later in follow-up after negative mycobacterial study including bronchoscopy

2015 ◽  
Vol 109 (10) ◽  
pp. 1347-1353
Author(s):  
Kazuya Koyama ◽  
Nobuharu Ohshima ◽  
Masahiro Kawashima ◽  
Kenichi Okuda ◽  
Ryota Sato ◽  
...  
Keyword(s):  
Mycobacterium Avium ◽  
Mycobacterium Avium Complex ◽  
Complex Disease ◽  
Mycobacterium Avium Complex Disease

Long-term Follow-up of Mycobacterium avium Complex Lung Disease in Patients Treated With Regimens Including Clofazimine and/or Rifampin

CHEST Journal ◽  
2016 ◽  
Vol 149 (5) ◽  
pp. 1285-1293 ◽  
Author(s):  
Julie Jarand ◽  
J. Paul Davis ◽  
Robert L. Cowie ◽  
Stephen K. Field ◽  
Dina A. Fisher
Keyword(s):  
Lung Disease ◽  
Mycobacterium Avium ◽  
Mycobacterium Avium Complex ◽  
Long Term Follow Up

Nontuberculous Mycobacteria

2021 ◽  
Vol 42 (04) ◽  
pp. 567-586
Author(s):  
Shera Tan ◽  
Shannon Kasperbauer
Keyword(s):  
Risk Factor ◽  
Pulmonary Disease ◽  
Mycobacterium Avium ◽  
Mycobacterium Avium Complex ◽  
Nontuberculous Mycobacteria ◽  
Mycobacterium Abscessus ◽  
Pulmonary Infections ◽  
Human Pathogens ◽  
Common Manifestation

AbstractNontuberculous mycobacteria (NTM) are ubiquitous in the environment and 193 species of NTM have been discovered thus far. NTM species vary in virulence from benign environmental organisms to difficult-to-treat human pathogens. Pulmonary infections remain the most common manifestation of NTM disease in humans and bronchiectasis continues to be a major risk factor for NTM pulmonary disease (NTM PD). This article will provide a useful introduction and framework for clinicians involved in the management of bronchiectasis and NTM. It includes an overview of the epidemiology, pathogenesis, diagnosis, and management of NTM PD. We will address the challenges faced in the diagnosis of NTM PD and the importance of subspeciation in guiding treatment and follow-up, especially in Mycobacterium abscessus infections. The treatment of both Mycobacterium avium complex and M. abscessus, the two most common NTM species known to cause disease, will be discussed in detail. Elements of the recent ATS/ERS/ESCMID/IDSA NTM guidelines published in 2020 will also be reviewed.

Osteomyelitis of the spine caused by mycobacterium avium complex in an immunocompetent patient

2013 ◽  
Vol 18 (3) ◽  
pp. 490-495 ◽  
Author(s):  
Tetsuya Suzuki ◽  
Hajime Murai ◽  
Naohisa Miyakoshi ◽  
Michio Hongo ◽  
Yoichi Shimada ◽  
...  
Keyword(s):  
Mycobacterium Avium ◽  
Mycobacterium Avium Complex ◽  
Immunocompetent Patient

scholarly journals Mycobacterium avium Auricular Infection in an Apparent Immunocompetent Patient: A Case Report

Folia Medica ◽  
2016 ◽  
Vol 58 (2) ◽  
pp. 131-135
Author(s):  
Panagiota Vlachogianni ◽  
Maria Volosyraki ◽  
Maria Stefanidou ◽  
Sabine Krueger-Krasagakis ◽  
George Evangelou ◽  
...  
Keyword(s):  
Case Report ◽  
Mycobacterium Avium ◽  
Mycobacterium Avium Complex ◽  
Immunocompetent Patient ◽  
Soft Tissue Infections ◽  
Tissue Cultures ◽  
Blood Tests ◽  
Ear Injury ◽  
The Right ◽  
Immunocompetent Patients

Abstract Introduction: Soft tissue infections with Mycobacterium avium complex are more likely to appear in immunocompromised patients. However, they may rarely arise in non-immunosuppressed individuals. Aim: To present the case of an ear infection with Mycobacterium avium in the absence of demonstrable immunosuppression. Case Report: Clinical case description, blood tests, routine histology and tissue cultures. Discussion: A female, apparent immunocompetent patient presented with a 6-month reddish, oedematous and painless lesion with fine scaling in the right ear. Histology showed numerous granulomas, composed of epithelioid histiocytes without central necrosis. Cultures grew Mycobacterium avium. An unusual accidental ear injury was the portal of microbial entry. The patient’s lesion fully regressed after a 9-month course of antibiotics. Conclusion: Although M. avium infections are rare in immunocompetent patients, the possibility of such infections should be considered even in these subjects, when relevant clinical features and exposure to risk factors are present.

scholarly journals Pleural Mycobacterium Avium Complex Infection in an Immunocompetent Female with No Risk Factors

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Ravi P. Manglani ◽  
Misbahuddin Khaja ◽  
Karen Hennessey ◽  
Omonuwa Kennedy
Keyword(s):  
Pleural Effusion ◽  
Mycobacterium Avium ◽  
Mycobacterium Avium Complex ◽  
Thoracoscopic Surgery ◽  
Immunocompetent Patient ◽  
Causative Organism ◽  
Pleural Biopsy ◽  
Healthy Female ◽  
Chest X Ray ◽  
High Index Of Suspicion

Mycobacterium avium complex (MAC) infections rarely affect the pleura, accounting for 5–15% of pulmonary MAC. We report a case of MAC pleural effusion in an otherwise immunocompetent young patient. A 37-year-old healthy female with no past medical history was admitted to the hospital with two weeks of right sided pleuritic chest pain, productive cough, and fever. She was febrile, tachycardic, and tachypneic with signs of right sided pleural effusion which were confirmed by chest X-ray and chest CT. Thoracentesis revealed lymphocytic predominant exudative fluid. The patient underwent pleural biopsy, bronchoscopy with bronchoalveolar lavage, and video assisted thoracoscopic surgery (VATS), all of which failed to identify the causative organism. Six weeks later, MAC was identified in the pleural fluid and pleural biopsy by DNA hybridization and culture. The patient was started on clarithromycin, ethambutol, and rifampin. After six months of treatment, she was asymptomatic with complete radiological resolution of the effusion. The presence of lymphocytic effusion should raise the suspicion for both tuberculous and nontuberculous mycobacterial disease. Pleural biopsy must be considered to make the diagnosis. Clinicians must maintain a high index of suspicion of MAC infection in an otherwise immunocompetent patient presenting with a unilateral lymphocytic exudative effusion.

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