0
Chest Infections: Student/Resident Case Report Poster - Chest Infections I |

Mycobacterium Abscessus Lung Infection Associated With Achalasia

Bhisham Harchandani, MBBS; Adam Austin, MD; Richard Blinkhorn, MD
Author and Funding Information

Albany Medical Center, Albany, NY


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;150(4_S):173A. doi:10.1016/j.chest.2016.08.182
Text Size: A A A
Published online

Extract

SESSION TITLE: Student/Resident Case Report Poster - Chest Infections I

SESSION TYPE: Student/Resident Case Report Poster

PRESENTED ON: Tuesday, October 25, 2016 at 01:30 PM - 02:30 PM

INTRODUCTION: Presenting a case of atypical mycobacterium in a patient with achalasia and challenges in its diagnosis and treatment.

CASE PRESENTATION: A 36-year-old man with Achalasia Cardia since his youth presented with 6 month history of non-productive cough and 3 week history of fever, chills and dysphagia prior to admission. Esophagogram revealed severe achalasia. He underwent Heller myotomy and fundoplication with resolution of his dysphagia. During this hospitalization he also had left lower lobe consolidation consistent with aspiration. He was subsequently discharged on oral antibiotics. He was readmitted two weeks later with worsening cough and an enlarging left lower lobe organizing pneumonia. Due to a suspicion of cryptogenic organizing pneumonia (COP), he was initially treated with prednisone with improvement in symptoms. A sputum culture grew acid fast bacilli subsequently identified as Mycobacterium abscessus positive for erm(41) gene. Bronchoalveolar lavage and multiple additional sputum samples were AFB culture-negative. Steroids were continued for suspected COP with symptomatic improvement but without radiologic improvement. Percutaneous lung biopsy revealed necrotizing granulomatous inflammation; smears and culture negative for AFB. Tigecycline, linezolid and amikacin were administered in preparation for planned surgical resection. Follow up chest CT two months into therapy showed persistent but decreasing size of the lower lobe consolidation.

First Page Preview

View Large
First page PDF preview

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543