RT Journal Article
SR Electronic
T1 Mycobacterium abscessus diagnosed in hemoculture
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P4358
VO 42
IS Suppl 57
A1 Ersan Atahan
A1 Benan Musellim
A1 Hakan Kalyoncu
A1 Gökhan Aygun
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P4358.abstract
AB A 23 y/o female admitted with complaints of fewer, dyspnea, and cough for a month. She was diagnosed systemic lupus erytematotus (SLE) at 2006 and taking prednisolone and azothiopurin medication. Alveolar hemorrage had been developed once during 6 years follow up. Bilateral alveolar opacities were seen on chest X-ray, Sputum AFB staining was negative and meropenem + trimetoprim/sulfametaxazol were administered emprically. Leucocyte ;2300 /mm3, hemoglobin: 7.9 g/dl, ESR: 89 mm/h, CRP: 121. pO2 was 61 mmHg; remaining biochemical parameters were normal. Mediastinal, hilar subcarinal conglomerated lymphadenomegaly and extensive interlobular septal thickening and ground glass opacities were seen bilateral lung parenchima on Thorax CT. Gram (+) bacili growed on hemoculture. Linesolid and amicacine were added to therapy. Echocardiography excluded possible rhodococcus endocarditis. Since no response to antibiotherapy, bronchoalveolar lavage was obtained. EZN (+) bacili was detected on lavage. The agent was gram (+) and did not considered Mycobacterium tuberculosis. Claritromycine was added for possible atypical mycobacteria. Clinical improvement was seen and acute phase reactants decreased. Mycobacterium abscessus was detected by PCR at both hemoculture and bronchoalveolar lavage and confirmed at another accredited laboratory. It was sensitive to claritromycine and amicasine and semi sensitive to linesolide. Linesolide was discontinued at first month and continued with amicasine and claritromycine. Alveolar opacities were recovered and hypoxia was improved. Amicasine was discontinued at 2nd month. She was stabile on 6th month therapy of claritromycine.