Case Report

Disseminated Mycobacterium interjectum Infection with Bacteremia, Hepatic and Pulmonary Involvement Associated with a Long-Term Catheter Infection

Table 1

Reported Mycobacterium interjectum cases in adults.

CaseAge (years/sex)RefLocationSymptomsPredisposing conditionsTreatmentOutcomeResistance pattern

(1)74/F[2]LungsPersistent coughHistory of possible tuberculosis and obstructive and restrictive pulmonary diseaseR, E, and sulfamethoxazole for 4 years inhaled Am indefinitelyImprovement of symptomsRes: H, E, PAS, aminoglycosides, and quinolones
Sus: Clr, Cfz, R, and Rfb
(2)62/M[5]Lung2 months of cough, night sweats, and weight lossTobacco useAm, TMP/SMX, and R for 2 months Clr, TMP/SMX, R, and E to complete 18 monthsCuredSus: R, Rfb, Clr, S, Cfz, Am, and TMP/SMX
Res: E, Cip
(3)52/M[15]Lung2 weeks of fever, malaise, and hemoptysisSmokerR, H, Z, and E for 2 months R, H to complete one yearCuredRes: R, E
(4)48/M[16]Lung2 weeks of cough, night sweats, and hemoptysisNoneR, H, and Z for 8 weeks R, H for 4 months after recurrence he was started on Clr, Lfx, R, and S for 9 months (planned for 2 years)Recurrence at 18 months later. Eventually improvedRes: R, H, Z, E, Lzd, and Dox
Sus: Clr, Lfx, and S
(5)77/F[17]SkinSubcutaneous nodules and abscessesMicroscopic polyangiitis, diabetes, chronic interstitial pneumonia, chronic steroids, and azathioprineSurgical excisionCuredRes: S, E, Km, H, R, Lfx, Clr, ethionamide, and Am
(6)49/F[18]Cerebrospinal fluid6 months of weight loss, visual disturbances, anorexia, poor memory, and episodic headachesAlcoholism, coinfection with Mycobacterium malmoenseR, H, Z, and E for 2 years (Dexamethasone initially used)ImprovedN/A
(7)49/FOur caseBlood, liver, and catheter tip1 year of fever/chills/night sweats and weight lossMalnutrition secondary to bariatric surgeryAzm, E, R, and Am for 10 weeks Azm, E, and R for 5 weeks Azm, Cip, and Rfb for 9 monthsCuredSus; Am, Cip, Clr, Lzd, Rfb, Mfx, and TMP/SMX
Res: Dox, E, and R

Ref: reference, Res: resistant, Sus: susceptible, Am: amikacin, Azm: azithromycin, H: isoniazid, R: rifampin, Rfb: rifabutin, E: ethambutol, Clr: clarithromycin, Cip: ciprofloxacin, Cfz: clofazimine, Dox: doxycycline, Z: pyrazinamide, PAS: p-aminosalicylic acid, Lfx: levofloxacin, Lzd: linezolid, S: streptomycin, TMP/SMX: trimethoprim/sulfamethoxazole, : followed by, N/A: not available.