A disseminated Mycobacterium marinum infection in a renal transplant HIV-infected patient successfully treated with a bedaquiline-containing antimycobacterial treatment: A case report.
Int J Infect Dis 2021;
107:176-178. [PMID:
33872782 DOI:
10.1016/j.ijid.2021.04.054]
[Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND
Disseminated Mycobacterium marinum infections occur rarely, in immunocompromised patients. Treatment with a prolonged multi-drug regimen exposes patients to drug-drug interactions and side effects.
CASE REPORT
We report a case of disseminated M. marinum infection in a 54-year-old renal transplant, HIV-infected woman. Manifestations of the infection were cutaneous and subcutaneous nodules, mediastinal lymph nodes and left pulmonary infiltrate. Empirical treatment for non-tuberculous mycobacteria was initiated with rifabutin, ethambutol and azithromycin. After identifying M. marinum in sputum, due to unfavourable clinical evolution and severe drug-related adverse events, treatment was changed to doxycycline and rifabutin. Digestive and haematologic side effects motivated a change in antimycobacterial treatment to a combination of moxifloxacin and bedaquiline. Tolerance was satisfactory, and the patient was cured after 12 months of treatment.
CONCLUSION
We report (to the authors' knowledge) the first case of disseminated M. marinum infection successfully treated with a bedaquiline-containing regimen. Bedaquiline could be an alternative to recommended antimicrobial regimens in cases of non-tuberculous mycobacterial disease, including M. marinum infection.
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