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Pulmonary Mycobacterium celatum in an Immunocompetent Patient Successfully Treated With Antimicrobial Chemotherapy FREE TO VIEW

Abdulrahman Hakami, MBBS
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Sahlgrenska University Hospital, Gothenburg, Sweden

Chest. 2014;145(3_MeetingAbstracts):109A. doi:10.1378/chest.1824228
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SESSION TITLE: Infectious Disease Case Reports Posters III

SESSION TYPE: Case Report Poster

PRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PM

INTRODUCTION: Mycobacterium celatum was first described in 1993 and since then , sporadic reports have been published on the isolation of this mycobacterium from immunocomprised pateints. M. celatum is phenotypically similar to M. avium and M. xenopi. M. celatum is a recently described organism. Several reports exist in the literature establishing this organism as a convincing pathogen among Human Immunodeficiency Virus (HIV) seropositive patients. However, there is now evidence of its pathogenicity among individuals whose immune function is not profoundly impaired.

CASE PRESENTATION: 66 year old female Caucasian patient .Her medical history was unremarkable and no drug history. No history of latent TB in childhood. Chest xray showed nodular infiltration bilaterally . Referred to our hospital, the results of the clinical laboratory tests were unremarkable , apart from elevated erythrocyte sedementaion rate (ESR) and CRP. HIV antibody test was negative. Sputum test showed mycobacterium cellatum. CT showed nodular changes bilaterally with bronchiectasis baisly. Started with mycobutin, myambutol and zithromax . After one month, adverse effects with low white blod cells related to mycobutin ,therefore treatment was stopped. After tow months patient symtoms not improved, then treatment initiated again with same treatment and rifadin alternative to mycobuton. Patient improved with treatment 12 months, therere has been no recurrence of symtoms after treatment completion.

DISCUSSION: This report of a pulmonary infection with M. celatum indicates that not only the known non tuberculous mycobacteria, M. kansasi, M. avium and M.scrufulaceum, can cause infection in immunocompetent human. The organism was generally found to be susceptible to clarithromycin, azithromycin and ethambutol.Anumber of case reports of M. Celatum infections exist in the literature and treatment results are diverse. One patient died six weeks after starting anti mycobacterium therapy from complication that were apparently related tom the M.celatum infection .Cases report showed successful treatment with using antimicobacterial chemotherapy and combined pulmonary resection. Our patient completely recovered with treatment, no recur of symptoms and follow-up sputum and blood cultures were performed between 2 and 9 months after initiation of therapy and remained negative. Chest x-ray control showed decreased nodular infilteration..

CONCLUSIONS: Pulmonary infection with M.celatum in populations other than immunocompronised patient successfully treated with anti-microbial chemotherapyin considerable reduction in the illness associated with disease.

Reference #1: Ikegame S., Nagmatsu Y., Negata N., Mitarai K., Iwasaki Y., Harada C., Kumaoe H., Kawasaki M. and Kajiki A. Congenital Cystic Adenomatoid Malformation in Adulthood Complicated by Mycobacterium celatum Infection. (Intern Med 51: 2203-2207, 2012). Fukuoka University Chikushi Hospital,Japan.

Reference #2: Hee-Jung Jun,1 Nam Yong Lee,2 Jhingook Kim,3 and Won-Jung Koh1, Successful Treatment of Mycobacterium celatum Pulmonary Disease in an Immunocompetent PatientUsing Antimicobacterial Chemotherapy and Combined Pulmonary Resection. Yonsei Med J 51(6):980-983, 2010.

Reference #3: Tan C , Lai C , Chou C , and Hsueh P. Mycobacterium celatum pulmonary infection mimicking pulmonary tuberculosis in a patient with ankylosing spondylitis. Taiwan. 24 November 2008.

DISCLOSURE: The following authors have nothing to disclose: Abdulrahman Hakami

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