A Case of Delayed Refractory Mycobacterium mageritense Abdominal Wall Abscess in a Kidney Transplant Recipient

Mycobacterium mageritense (M. mageritense), a rare non-tuberculous mycobacterium (NTM), can cause infections in immunocompromised patients, including kidney transplant recipients. We present a case of an abdominal wall abscess caused by M. mageritense following a living donor kidney transplant.

A 58-year-old woman, post-ABO-incompatible kidney transplant, developed an abscess at the site of a removed peritoneal dialysis catheter. Initial antibiotics were ineffective, and pus cultures identified M. mageritense. Surgical drainage and levofloxacin-linezolid therapy controlled the infection temporarily. Despite clinical improvement, the abscess recurred 30 days post-discharge, which required repeated antibiotic use and adjustments to immunosuppression. Reducing mycophenolate mofetil while maintaining tacrolimus stabilized the infection, and prophylactic levofloxacin was continued post-discharge to prevent relapse.

Effective infection control requires careful immunosuppressive adjustment and long-term antibiotic use to balance graft preservation with infection risk.