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A rare case ofMycobacterium abscessussubspeciesabscessusprosthetic valve endocarditis and the clinical importance of inducibleerm(41) gene testing
- Source :
- BMJ Case Reports. :bcr-2017
- Publication Year :
- 2017
- Publisher :
- BMJ, 2017.
-
Abstract
- A 56-year-old man with a history of injection drug use and two prior episodes of native valve infective endocarditis presented with dyspnoea on exertion. Our preliminary work-up revealed bacteraemia with reported growth of 'Mycobacterium abscessus group' on multiple blood cultures. The patient was later found to have eustachian valve and prosthetic pulmonic valve endocarditis. Initially, he responded to standard antimycobacterial therapy for rapidly growing mycobacteria (RGM) with supporting laboratory susceptibilities. However, he later developed refractory disease and persistent bacteraemia in the setting of these alleged susceptible antibiotics. Further molecular testing revealed a functional and inducible erm(41) gene which confers macrolide resistance. A subspecies analysis of the M abscessus group revealed the subspecies to be abscessus We present a challenging case of M abscessus subsp. abscessus bacteraemia and prosthetic valve endocarditis with further discussion on treatment and management of this infection along with the taxonomic complexity of this ubiquitous RGM.
- Subjects :
- 0301 basic medicine
biology
medicine.drug_class
Mycobacterium abscessus subsp. abscessus
business.industry
030106 microbiology
Antibiotics
General Medicine
Mycobacterium abscessus
bacterial infections and mycoses
biology.organism_classification
medicine.disease
Microbiology
Eustachian Valve
03 medical and health sciences
0302 clinical medicine
Infective endocarditis
medicine
bacteria
030212 general & internal medicine
Prosthetic valve endocarditis
business
Gene
Rare disease
Subjects
Details
- ISSN :
- 1757790X
- Database :
- OpenAIRE
- Journal :
- BMJ Case Reports
- Accession number :
- edsair.doi...........6ac478568458d02395cedeadf0d44e29