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Nontuberculous mycobacterial infections in left ventricular assist device patients

Christopher Radcliffe1, Natnael Doilicho1, Matthew Grant1,2

  • 1Yale School of Medicine, New Haven, Connecticut.

Journal of Cardiac Surgery
|April 8, 2020
PubMed

Insights

Nontuberculous mycobacterial (NTM) infections, like Mycobacterium fortuitum, pose a rare but serious challenge in left ventricular assist device (LVAD) patients. This case highlights diagnostic difficulties and the need for further research into effective NTM infection management in LVAD recipients.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Device Technology

Background:

  • Left ventricular assist devices (LVADs) are critical for end-stage heart failure management.
  • LVAD infections are a significant complication, with Staphylococcal and Gram-negative bacteria being common culprits.
  • Nontuberculous mycobacterial (NTM) infections are an infrequent but reported complication.

Observation:

  • This report details a rare case of a driveline infection caused by Mycobacterium fortuitum in a 75-year-old male LVAD recipient.
  • The patient received a combination of meropenem, azithromycin, and ciprofloxacin.
  • Despite device exchange, the patient experienced a fatal neurological decline.

Findings:

  • Mycobacterium fortuitum, a rapidly growing NTM species, can cause challenging LVAD driveline infections.
  • NTM infections are difficult to diagnose due to biofilm formation and potential for negative cultures.
  • This case represents the second reported instance of Mycobacterium fortuitum driveline infection in an LVAD patient.

Implications:

  • Effective management strategies for NTM infections in LVAD patients are urgently needed.
  • Early and accurate diagnosis of NTM infections is crucial for improved patient outcomes.
  • Further research is required to address the literature gap concerning NTM infections in LVAD populations.
Keywords:
clinical reviewtransplant

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