Incidental intraoperative diagnosis of Mycobacterium abscessus meningeal infection: a case report and review of the literature

Francesca Giovannenze, Vito Stifano, Giancarlo Scoppettuolo, Fernando Damiano, Federico Pallavicini, Giovanni Delogu, Ivana Palucci, Alessandro Rapisarda, Cosimo Sturdà, Angelo Pompucci

Risultato della ricerca: Contributo in rivistaArticolo in rivista

1 Citazioni (Scopus)

Abstract

Purpose: Mycobacterium abscessus, and rapidly growing mycobacteria in general, are rare but increasing causes of central nervous system (CNS) infections. The aim of this study is to highlight the importance of considering these microorganism in the differential diagnosis of CNS infections, obtaining a prompt diagnosis, and improving clinical outcomes. Methods: Case report and literature review. Results: We report a case of meningeal infection in a patient who underwent decompressive craniectomy after a craniofacial trauma. The diagnosis was made analyzing a sample obtained during a second operation of cranioplasty. A regimen of amikacin, clarithromycin, and imipenem/cilastatin was started. In the following days, the patient experienced a variety of side effects. So, first clarithromycin was replaced with linezolid, then amikacin was stopped and cefoxitin added to the therapy and at the end all the antibiotics were withdrawn. The patient was discharged in good conditions and a clinical interdisciplinary follow-up was started. After 12 months, the patient is still doing well. After a literature analysis, 15 cases of M. abscessus CNS infections were identified. Various modes of acquisition, underlying disease and therapeutic schemes were evident. Conclusions: Considering the results of the literature analysis and the increasing incidence of M. abscessus, all specialists involved in the management of CNS infection should be aware of the importance of atypical microorganisms in differential diagnosis.
Lingua originaleEnglish
pagine (da-a)591-597
Numero di pagine7
RivistaInfection
Volume46
DOI
Stato di pubblicazionePubblicato - 2018

Keywords

  • CNS infection
  • Infectious Diseases
  • Meningeal infection
  • Microbiology (medical)
  • Mycobacterium abscessus complex

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