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A mysterious gram-positive rods.

Javzandulam Natsag1, Zaw Min, Yasir Hamad

  • 1Department of Internal Medicine, MedStar Harbor Hospital, 3001 South Hanover Street, Baltimore, MD 21225, USA.

Case Reports in Infectious Diseases
|September 8, 2012
PubMed
Summary
This summary is machine-generated.

A rare case of disseminated Mycobacterium fortuitum infection occurred in an immunocompetent intravenous drug user, leading to endocarditis and hepatitis. Tap water used for drug preparation was the suspected source of this unusual bacterial sepsis.

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Area of Science:

  • Infectious Diseases
  • Microbiology
  • Public Health

Background:

  • Mycobacterium fortuitum is a rapidly growing non-tuberculous mycobacterium, ubiquitous in the environment.
  • Disseminated M. fortuitum infections are rare, particularly in immunocompetent individuals.
  • Intravenous drug use is a known risk factor for various infections, but M. fortuitum sepsis is uncommon.

Purpose of the Study:

  • To report an extremely rare case of disseminated Mycobacterium fortuitum infection.
  • To highlight the potential source and clinical presentation of M. fortuitum sepsis in an immunocompetent host.
  • To discuss the implications for infection control among intravenous drug users.

Main Methods:

  • Case report of a patient with intravenous drug use history.
  • Identification of Mycobacterium fortuitum from blood cultures.
  • Diagnostic investigations including transesophageal echocardiogram and liver biopsy.
  • Clinical monitoring of response to antibiotic treatment.

Main Results:

  • The patient presented with fever, malaise, nausea, and cavitary lung lesions.
  • Blood cultures yielded Mycobacterium fortuitum, identified as the cause of sepsis.
  • Infective endocarditis (aortic and tricuspid valves) and granulomatous hepatitis were diagnosed.
  • Serum alkaline phosphatase levels decreased with antibiotic therapy.

Conclusions:

  • Disseminated Mycobacterium fortuitum infection can occur in immunocompetent individuals, especially those with risk factors like intravenous drug use.
  • Contaminated tap water used for drug preparation is a plausible source of M. fortuitum infection.
  • Prompt diagnosis and appropriate antibiotic treatment are crucial for managing M. fortuitum sepsis and its complications.