Mycobacterium paragordonae pulmonary disease with rapidly growing solitary lesions: a case report and literature review
Introduction: Mycobacterium paragordonae (MPG) is a novel and uncommon nontuberculous mycobacterium (NTM). We describe a case of MPG pulmonary disease (MPGPD) with a single, rapidly growing, pulmonary mass, which has rarely been reported. Case report: A chest CT scan of a 66-year-old woman reveal...
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The Journal of Infection in Developing Countries
2024-10-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/18664 |
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| author | Wei-wei He Wen-jing Wang Zhi-xin Huang Yu-lei Li Qiu-yuan Xia Yi Shi Bin Yang Hui-ming Sun |
| author_facet | Wei-wei He Wen-jing Wang Zhi-xin Huang Yu-lei Li Qiu-yuan Xia Yi Shi Bin Yang Hui-ming Sun |
| author_sort | Wei-wei He |
| collection | DOAJ |
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Introduction: Mycobacterium paragordonae (MPG) is a novel and uncommon nontuberculous mycobacterium (NTM). We describe a case of MPG pulmonary disease (MPGPD) with a single, rapidly growing, pulmonary mass, which has rarely been reported.
Case report: A chest CT scan of a 66-year-old woman revealed a rapidly growing solitary mass-like lesion in the upper lobe of the right lung, which was not seen in the previous chest CT scan six months ago. H&E-stained section of the CT-guided percutaneous lung tissue biopsy specimen showed chronic inflammatory changes with epithelioid granulomas. Metagenomic next-generation sequencing (mNGS) of lung tissue biopsy specimen identified MPG with a sequence number of 1617 and a confidence level of 99%. Because the subsequent MPG droplet digital PCR (MPG-ddPCR) test of the lung tissue biopsy was positive, she was eventually diagnosed with MPGPD. She was administered a quadruple oral regimen comprising clarithromycin, levofloxacin, rifampicin, and ethambutol according to the ATS/IDSA protocol for Mycobacterium gordonae (MG) infection. The chest CT scans showed a significant reduction in the lesion one month after the treatment and almost complete resolution four months later.
Conclusions: MPGPD is a rare NTM infection. The imaging manifestations of MPGPD are diverse and may even show rapid development. mNGS of tissue biopsy can enable prompt diagnosis of MPG infection and is a good alternative to routine NTM microbial testing. The ATS/IDSA protocol for MG infection is an effective treatment for MPG infection.
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| format | Article |
| id | doaj-art-294afb3847bf4a4daae76b2e28cbafbc |
| institution | DOAJ |
| issn | 1972-2680 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | The Journal of Infection in Developing Countries |
| record_format | Article |
| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-294afb3847bf4a4daae76b2e28cbafbc2025-08-20T02:57:20ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802024-10-01181010.3855/jidc.18664Mycobacterium paragordonae pulmonary disease with rapidly growing solitary lesions: a case report and literature reviewWei-wei He0Wen-jing Wang1Zhi-xin Huang2Yu-lei Li3Qiu-yuan Xia4Yi Shi5Bin Yang6Hui-ming Sun7Department of Respiratory and Critical Care Medicine, Nanjing Yimin Hospital, Nanjing, Jiangsu Province, ChinaDepartment of Respiratory and Critical Care Medicine, Nanjing Yimin Hospital, Nanjing, Jiangsu Province, ChinaDepartment of Respiratory and Critical Care Medicine, Nanjing Yimin Hospital, Nanjing, Jiangsu Province, ChinaDepartment of Respiratory and Critical Care Medicine, Nanjing Yimin Hospital, Nanjing, Jiangsu Province, ChinaDepartment of Pathology, Jinling Hospital, Nanjing, Jiangsu Province, ChinaDepartment of Respiratory and Critical Care Medicine, Jinling Hospital, Nanjing, Jiangsu Province, ChinaCenter of Infectious Diseases, Vision Medicals Co., Ltd, Guangzhou, Guangdong Province, ChinaDepartment of Respiratory and Critical Care Medicine, Nanjing Yimin Hospital, Nanjing, Jiangsu Province, China Introduction: Mycobacterium paragordonae (MPG) is a novel and uncommon nontuberculous mycobacterium (NTM). We describe a case of MPG pulmonary disease (MPGPD) with a single, rapidly growing, pulmonary mass, which has rarely been reported. Case report: A chest CT scan of a 66-year-old woman revealed a rapidly growing solitary mass-like lesion in the upper lobe of the right lung, which was not seen in the previous chest CT scan six months ago. H&E-stained section of the CT-guided percutaneous lung tissue biopsy specimen showed chronic inflammatory changes with epithelioid granulomas. Metagenomic next-generation sequencing (mNGS) of lung tissue biopsy specimen identified MPG with a sequence number of 1617 and a confidence level of 99%. Because the subsequent MPG droplet digital PCR (MPG-ddPCR) test of the lung tissue biopsy was positive, she was eventually diagnosed with MPGPD. She was administered a quadruple oral regimen comprising clarithromycin, levofloxacin, rifampicin, and ethambutol according to the ATS/IDSA protocol for Mycobacterium gordonae (MG) infection. The chest CT scans showed a significant reduction in the lesion one month after the treatment and almost complete resolution four months later. Conclusions: MPGPD is a rare NTM infection. The imaging manifestations of MPGPD are diverse and may even show rapid development. mNGS of tissue biopsy can enable prompt diagnosis of MPG infection and is a good alternative to routine NTM microbial testing. The ATS/IDSA protocol for MG infection is an effective treatment for MPG infection. https://jidc.org/index.php/journal/article/view/18664Mycobacterium paragordonaenontuberculous mycobacteriummetagenomic next-generation sequencinglung biopsy |
| spellingShingle | Wei-wei He Wen-jing Wang Zhi-xin Huang Yu-lei Li Qiu-yuan Xia Yi Shi Bin Yang Hui-ming Sun Mycobacterium paragordonae pulmonary disease with rapidly growing solitary lesions: a case report and literature review Journal of Infection in Developing Countries Mycobacterium paragordonae nontuberculous mycobacterium metagenomic next-generation sequencing lung biopsy |
| title | Mycobacterium paragordonae pulmonary disease with rapidly growing solitary lesions: a case report and literature review |
| title_full | Mycobacterium paragordonae pulmonary disease with rapidly growing solitary lesions: a case report and literature review |
| title_fullStr | Mycobacterium paragordonae pulmonary disease with rapidly growing solitary lesions: a case report and literature review |
| title_full_unstemmed | Mycobacterium paragordonae pulmonary disease with rapidly growing solitary lesions: a case report and literature review |
| title_short | Mycobacterium paragordonae pulmonary disease with rapidly growing solitary lesions: a case report and literature review |
| title_sort | mycobacterium paragordonae pulmonary disease with rapidly growing solitary lesions a case report and literature review |
| topic | Mycobacterium paragordonae nontuberculous mycobacterium metagenomic next-generation sequencing lung biopsy |
| url | https://jidc.org/index.php/journal/article/view/18664 |
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