Mycobacterium goodii pneumonia: An unusual presentation of nontuberculous mycobacterial infection requiring a novel multidisciplinary approach to management

• Published in: Respiratory medicine case reports Vol. 26; pp. 307 - 309
• Main Authors: Waldron, Ruth, Waldron, Dympna, McMahon, Eileen, Reilly, Leona, Riain, Una Ni, Fleming, Catherine, O'Regan, Anthony
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.01.2019; Elsevier
• Subjects: Atypical pneumonia; Case Report; Mycobacterium goodii; Nontuberculous mycobacteria; Quality of life; Symptom control; Mycobacterium goodii; Symptom control; Nontuberculous mycobacteria; Atypical pneumonia; Quality of life
• ISSN: 2213-0071; 2213-0071
• DOI: 10.1016/j.rmcr.2019.02.022

Mycobacterium goodii is a rapidly growing nontuberculous mycobacterium which has been associated with several infections including cellulitis, osteomyelitis, lymphadenitis, infected pacemakers and bursitis but it is a rare cause of respiratory infection. In this case report we describe a 51-year-old woman who presented with a 6-week history of non-productive cough, pleuritic chest pain and weight loss. She had a history of gastric adenocarcinoma managed with a distal oesophagectomy and total gastrectomy and consequentially suffered severe post-operative gastric reflux. Initial cultures were negative but following a VATS lung biopsy Mycobacterium goodii was cultured and histology revealed an organising pneumonia. Treatment was with a prolonged course of steroids, amikacin and meropenem followed by oral ciprofloxacin and doxycycline. Ongoing gastric dysmotility and weight loss showed clinical improvement with a novel approach of a combination of prokinetics and somatostatin analogues controlling risk of repeat aspiration and improving symptom control. This is an unusual case of organising pneumonia related to Mycobacterium goodii infection and highlights the importance of mycobacterial culture in unusual and unresolving cases of organising pneumonia. The importance of controlling symptoms related to gastric dysmotility and aspiration is also addressed.