Successful treatment of rapid growing mycobacterial infections with source control alone: Case series

Treatment of non-tuberculosis mycobacteria skin infections

Non-tuberculosis mycobacteria (NTM) skin infections have become increasingly prevalent in recent years, presenting a unique challenge in clinical management. This review explored the complexities of NTM infections localized to the superficial tissues and provided valuable insights into the optimal therapeutic strategies. The antibiotic selection should base on NTM species and their susceptibility profiles. It is recommended to adopt a comprehensive approach that considers the unique characteristics of superficial tissues to improve treatment effectiveness and reduce the incidence of adverse reactions, infection recurrence, and treatment failure. Infection control measures, patient education, and close monitoring should complement the treatment strategies to achieve favorable outcomes in managing NTM skin infections. Further efforts are warranted to elucidate factors and mechanisms contributing to treatment resistance and relapse. Future research should focus on exploring novel treatment options, innovative drug development/delivery platforms, and precise methodologies for determining therapeutic duration. Longitudinal studies are also needed to assess the long-term safety profiles of the integrated approaches.

An Immunocompetent Adult Male Presented with a Liver Abscess Caused by the Mycobacterium tuberculosis: A Case Report from India

A liver abscess is a collection of purulent fluid in the liver parenchyma caused by a variety of etiological organisms such as bacteria, protozoa, and in rare occasions fungi. Mycobacterium tuberculosis (MTB) is a frequent and widespread infection in underdeveloped nations such as India, which can manifest in many ways. Tuberculosis mostly affects the lungs, although it can also affect any organ in the body. We are reporting a case of liver abscess caused by MTB infection in order to raise general awareness among physicians about the importance of suspecting and ruling out tuberculosis as a cause of liver abscess. To the best of our knowledge, there have been very few such cases reported from India/the rest of the world.

Mycobacterium abscessus Complex Osteomyelitis of the Wrist

Mycobacterium abscessus (M. abscessus) is a ubiquitous, rapidly growing non-tuberculous mycobacterium, which is known to cause life-threatening lung infections in immunocompromised individuals following exposure to contaminated injectable products. We report a case of M. abscessus osteomyelitis of the right wrist in a 28-year-old patient with a history of intravenous drug use and a recent surgical repair of the right radial artery pseudoaneurysm. The patient underwent surgical debridement of the right distal radius infection. Histopathological examination and culture of the debrided tissue revealed M. abscessus complex infection. The patient was placed on intravenous amikacin, azithromycin, and cefoxitin for six weeks, followed by oral linezolid and clofazimine for six months.

T-Cell Exhaustion in Mycobacterium tuberculosis and Nontuberculous Mycobacteria Infection: Pathophysiology and Therapeutic Perspectives

Immune exhaustion is a condition associated with chronic infections and cancers, characterized by the inability of antigen-specific T cells to eliminate the cognate antigen. Exhausted T cells display a peculiar phenotypic profile and exclusive functional characteristics. Immune exhaustion has been described in patients with Mycobacterium tuberculosis infection, and cases of tuberculosis reactivation have been reported in those treated with immune checkpoint inhibitors, drugs able to re-establish T-cells’ function. Exhausted T CD8⁺ cells’ profile has also been described in patients with infection due to nontuberculous mycobacteria. In this review, we initially provide an overview of the mechanisms leading to immune exhaustion in patients infected by Mycobacterium tuberculosis and nontuberculous mycobacteria. We then dissect the therapeutic perspectives related to immune checkpoint blockade in patients with these infections.