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Mycobacterium abscessus complex lung infection in a toddler with a tracheostomy
Kensho Iwanaga1, Edward R Carter
1Division of Pulmonary and Sleep Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington; Seattle Children's Hospital, Seattle, Washington.
Insights
Mycobacterium abscessus complex lung infections are rare in children with tracheostomies. A young girl with a tracheostomy experienced significant recovery after long-term anti-mycobacterial treatment for this infection.
Area of Science:
- Pulmonology
- Infectious Diseases
- Pediatric Respiratory Medicine
Background:
- Non-tuberculous mycobacteria, including Mycobacterium abscessus complex, are uncommon respiratory pathogens.
- Patients with tracheostomies, particularly those with underlying conditions like bronchopulmonary dysplasia and laryngeal stenosis, may be at risk.
- Respiratory infections in this population require careful diagnosis and management.
Observation:
- A 4-year-old girl with a history of tracheostomy since infancy presented with a lung infection.
- The infection was confirmed as Mycobacterium abscessus complex, showing parenchymal involvement beyond simple colonization.
- The patient had severe bronchopulmonary dysplasia and laryngeal stenosis contributing to her respiratory vulnerability.
Findings:
- The patient received prolonged anti-mycobacterial therapy tailored to the identified pathogen.
- Significant clinical improvement was observed, including resolution of symptoms and signs of infection.
- Laboratory markers and radiographic findings also demonstrated a dramatic positive response to treatment.
Implications:
- This case highlights the importance of considering Mycobacterium abscessus complex in pediatric tracheostomy patients with respiratory symptoms.
- Prolonged and appropriate anti-mycobacterial therapy can lead to successful outcomes in these challenging infections.
- Further research into the pathogenesis and optimal treatment strategies for non-tuberculous mycobacterial lung disease in vulnerable pediatric populations is warranted.
Abstract:
Mycobacterium abscessus complex and other non-tuberculous mycobacteria are infrequently encountered respiratory pathogens in patients with tracheostomies. We report a 4-year-old girl with a tracheostomy, placed during infancy for management of severe bronchopulmonary dysplasia and laryngeal stenosis, who developed a M. abscessus complex lung infection. There was clear evidence of parenchymal involvement and true infection beyond colonization. She demonstrated dramatic clinical, laboratory, and radiographic improvement after prolonged anti-mycobacterial therapy.
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