Case Report
Successful Antibiotic Treatment of Mycobacterium abscessus Pulmonary Disease in an Immunocompetent Individual
| Anna Beltrame1* Giovanni Cattani1 Federica Brillo1 Maria Merelli1 Claudio Scarparo2 Giuseppe Como3 Maria Consuelo Screm2 Tortoli4 Alberto Matteell5 | ||
| 1Clinic of Infectious Diseases, S.M. Misericordia University Hospital, P.le S.M. Misericordia 15, 33100 Udine, Italy | ||
| 2Microbiology Department, S.M. Misericordia University Hospital, Udine, Italy | ||
| 3Institute of Diagnostic Radiology, S.M. Misericordia University Hospital, Udine, Italy | ||
| 4Regional Reference Center for Mycobacteria, Microbiology and Virology Laboratory, Careggi University Hospital, Firenze, Italy | ||
| 5Institute of Infectious and Tropical Diseases, Spedali Civili University Hospital, Brescia, Italy | ||
| Corresponding Author : | Anna Beltrame Clinic of Infectious Diseases S.M. Misericordia University Hospital P.le S.M. Misericordia 15 33100 Udine, Italy Tel: +39.0432 559354 Fax: +39.0432 559360 E-mail: beltrame.anna@aoud.sanita.fvg.it |
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| Received March 18, 2013; Accepted April 08, 2013; Published April 13, 2013 | ||
| Citation: Beltrame A, Cattani G, Screm MC, Brillo F, Merelli M, et al. (2013) Successful Antibiotic Treatment of Mycobacterium abscessus Pulmonary Disease in an Immunocompetent Individual. J Infect Dis Ther 1:103. doi:10.4172/2332-0877.1000103 | ||
| Copyright: © 2013 Beltrame A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. | ||
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Abstract
The number of subjects with Mycobacterium abscessus lung disease is increasing. The optimal treatment to prevent clinical relapse in these patients has not been well established. At times, antibiotic regimens have also been shown to produce long-term sputum conversion. We describe a case of M. abscessus lung disease in an immunocompetent individual with successful outcome at 24 months, following antibiotic therapy. Initially, an empirical treatment was started intravenously with amikacin (700 mg once-daily), cefoxitin (4 g every 8 h), and oral clarithromycin (500 mg twice daily). Although, the symptoms resolved rapidly, the anti-mycobacterial drugs were discontinued three weeks later, following the onset of hepatotoxicity. Two weeks after discontinuation of therapy, the liver enzymes were returned to normal levels, and amikacin and clarithromycin were reintroduced and continued for another 8 months, when the individual developed hearing loss, which led to further discontinuation of antibiotic therapy. During the subsequent 24 months, broncoscopy, sputum AFB examination and mycobacterial culture were negative. Our management suggests that prompt, individualized and protracted treatment can be curative, in case of mild disease.
