Diagnosis of Pulmonary Disease Caused by Mycobacterium Abscessus: A Case Report

• Published in: Journal of international medical research Vol. 39; no. 3; pp. 968 - 975
• Main Authors: Zhao, P, Zhang, YY, Li, YB, Zhu, Y, Wan, KL
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.06.2011
• Subjects: Antitubercular Agents - therapeutic use; Base Sequence; DNA Primers; Humans; Male; Middle Aged; Mycobacterium - isolation & purification; Mycobacterium Infections - diagnosis; Mycobacterium Infections - diagnostic imaging; Mycobacterium Infections - drug therapy; Mycobacterium Infections - microbiology; Polymerase Chain Reaction; Polymorphism, Restriction Fragment Length; Radiography; Pulmonary disease; Mycobacterium abscessus; Acid-fast bacillus; Non-tuberculous mycobacterium
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/147323001103900332

Mycobacterium abscessus (M. abscessus) is a non-tuberculous mycobacterium and an important emerging pathogen causing skin, soft tissue and pulmonary infections. The case of a 59-year-old man with a history of pulmonary tuberculosis (TB) and current pulmonary infection due to M. abscessus, complicated with pneumocardial disease and bronchiectasis, is described. Zhiel—Neelsen stain and acid Lowenstein—Jensen culture were both positive for acid-fast bacillus. The patient was initially misdiagnosed and ineffectively treated for pulmonary TB. Antimycobacterial susceptibility tests found the isolate to be resistant to four first-line and seven second-line antituberculosis drugs. The isolate was finally identified as M. abscessus using 16S ribosomal RNA and hsp65 and rpoB gene sequence analysis. Species of mycobacterium should be included in the differential diagnosis when patients do not respond to standard antituberculosis therapy. Molecular methods are useful for rapid and species-specific identification.