First case report of infection by Mycobacterium wolinskyi after mammoplasty in Brazil

Mycotic abdominal aortic aneurysm: two cases caused by Salmonella enterica

A mycotic abdominal aortic aneurysm was detected on computed tomographic angiography of two male patients who were followed up after reporting symptoms of abdominal pain, malaise and fever of unknown origin. One of the patients' aneurysm was repaired with a tubular graft and the other patient had endovascular aneurysm repair due to his high co-morbidity. From pre-operative cultures and a pathological examination of the surgical specimens, it was observed that the aneurysms had developed in the abdominal aorta due to Salmonella enterica, and broad-spectrum antibiotic therapy was started. We present these two cases of mycotic aneurysm due to Salmonella. The patients were discharged after the postoperative course of antibiotic treatments were completed.

Abdominal Soft Tissue Infection Caused by Mycobacterium wolinskyi After Cosmetic Surgery: A Case Report

BACKGROUND

Mycobacterium wolinskyi is a rare, fast-growing, painful bacterium causing soft tissue infections. Sparse case reports focus on long-term intravenous antibiotic therapy and surgical interventions. We searched the literature and found almost no discussion about treatment from a nursing and wound care perspective.

CASE

Ms P, a 30-year-old Arabic female patient, underwent cosmetic surgery in Iraq including liposuction, abdominoplasty, and herniorrhaphy. One month postoperatively, she presented with an infection identified as M. wolinskyi resulting in multiple hospital admissions. Ms P received treatment with long-term antibiotic therapy and underwent multiple surgical debridements with extensive wound care management.

CONCLUSION

Mycobacterium wolinskyi is an exceedingly rare bacterium not typically seen in the clinical setting and requires prolonged and aggressive treatment. It is painful and fast-growing, as evidenced by multiple abscess formations and tissue necrosis in this case. Daily assessments and wound management using a collaborative approach were important to promote optimal healing.

First case report of prosthetic valve endocarditis caused by Mycobacterium wolinskyi

To date, only 26 cases of Mycobacterium wolinskyi infections have been reported in humans. We herein report a first case of prosthetic valve endocarditis due to this organism after cardiovascular surgery. An 82-year-old man presented with repeat episodes of syncope and fever after aortic valve replacement, mitral valve replacement, left atrial appendage closure, and pulmonary vein isolation. Blood cultures maintained in aerobic bottles were repeatedly positive after 90-100 hours, and Gallium scan revealed abnormal accumulations in the sternum and left testis. While colonies formed by culturing the fluid of the parasternal area and blood cultures revealed gram-positive rods, we could not analyze the colony using matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF). M. wolinskyi was finally identified on 16S rRNA, hsp65, and rpoB gene sequencing. We treated the patient with multiple antimycobacterial drugs, i.e., amikacin, imipenem, and clarithromycin for 6 weeks, which was changed to oral ciprofloxacin and minocycline for 12 months. This case highlights the need to consider rapidly growing mycobacteria, including M. wolinskyi, if chronic fever persists from weeks to months after surgery, the blood culture is positive, and the organism is not identified. In addition, sequencing the 16S rRNA, hsp65, and rpoB genes is essential for diagnosis.

Mycobacterium wolinskyi Peritonitis after Peritoneal Catheter Embedment Surgery

Mycobacterium wolinskyi belongs to the Mycobacterium smegmatis group, which comprises rapidly growing non-tuberculous mycobacteria. The number of case reports on M. wolinskyi infections associated with postoperative wounds has increased in recent years. We herein report a case of peritonitis due to M. wolinskyi after peritoneal catheter embedment surgery. Identification was achieved based on 16S ribosomal RNA and rpoB gene sequencing of the isolate. The patient recovered following catheter removal and treatment with levofloxacin and minocycline for one month.

Ulcers as a Sign of Skin Infection with Mycobacterium wolinskyi: Report of a Case and Review of the Literature

Infection with Mycobacterium wolinskyi, if not detected, may cause severe skin and soft tissue infection with prolonged healing process and is therefore associated with high morbidity. Only about 20 cases of M. wolinskyi infections in humans have been described in the literature until now, none of them in Switzerland. We report a case of an infection in a 72-year-old male patient with recurrent subcutaneous abdominal wall abscesses and ulcer formation after insulin injection in the underbelly. A culture of skin biopsy tissue showed rapid growth of non-tuberculous mycobacteria (NTM), which were identified by 16S rRNA gene sequencing as M. wolinskyi. Surgical excision and primary closure of all abdominal ulcers in combination with antibiotic therapy, based on the antimicrobiotic susceptibility test results, were performed and resulted in complete resolution of the clinical symptoms and no recurrence of infection at a 6-month follow-up. The present case emphasizes the importance of accurate diagnosis and treatment of chronic infection with ulcer formation. In such cases, it is crucial to consider the presence of NTM, such as M. wolinskyi, in order to obtain rapid diagnosis, specific treatment and improved patient care.

Draft Genome Sequence of Mycobacterium wolinskyi, a Rapid-Growing Species of Nontuberculous Mycobacteria

Mycobacterium wolinskyi is a nonpigmented, rapidly growing nontuberculous mycobacterium species that is associated with bacteremia, peritonitis, infections associated with implants/prostheses, and skin and soft tissue infections often following surgical procedures in humans. Here, we report the first functionally annotated draft genome sequence of M. wolinskyi CDC_01.

The looming tide of nontuberculous mycobacterial infections in Portugal and Brazil

Nontuberculous mycobacteria (NTM) are widely disseminated in the environment and an emerging cause of infectious diseases worldwide. Their remarkable natural resistance to disinfectants and antibiotics and an ability to survive under low-nutrient conditions allows NTM to colonize and persist in man-made environments such as household and hospital water distribution systems. This overlap between human and NTM environments afforded new opportunities for human exposure, and for expression of their often neglected and underestimated pathogenic potential. Some risk factors predisposing to NTM disease have been identified and are mainly associated with immune fragilities of the human host. However, infections in apparently immunocompetent persons are also increasingly reported. The purpose of this review is to bring attention to this emerging health problem in Portugal and Brazil and to emphasize the urgent need for increased surveillance and more comprehensive epidemiological data in both countries, where such information is scarce and seriously thwarts the adoption of proper preventive strategies and therapeutic options.