A Mysterious Gram-Positive Rods
We encountered a patient with a history of intravenous drug use presenting with fever, malaise and nausea who was found to have cavitary lung lesions. Unexpectedly, gram positive rods grew out on day five on multiple blood cultures, which were later identified as Mycobacterium fortuitum. The patient...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Case Reports in Infectious Diseases |
| Online Access: | http://dx.doi.org/10.1155/2012/841834 |
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| _version_ | 1832564832896811008 |
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| author | Javzandulam Natsag Zaw Min Yasir Hamad Bassel Alkhalil Atiq Rahman Richard Williams |
| author_facet | Javzandulam Natsag Zaw Min Yasir Hamad Bassel Alkhalil Atiq Rahman Richard Williams |
| author_sort | Javzandulam Natsag |
| collection | DOAJ |
| description | We encountered a patient with a history of intravenous drug use presenting with fever, malaise and nausea who was found to have cavitary lung lesions. Unexpectedly, gram positive rods grew out on day five on multiple blood cultures, which were later identified as Mycobacterium fortuitum. The patient underwent transesophageal echocardiogram, which showed aortic and tricuspid valve vegetations. Liver biopsy demonstrated granulomatous hepatitis. Interestingly, serum alkaline phosphatase level fell with antibiotic treatment. Mycobacterium fortuitum is ubiquitous worldwide, being found in tap water, and soil. M. fortuitum is usually considered as a contaminant. Disseminated infection caused by this bacterium in an immunocompetent host is extremely rare. Most of the disseminated infections have been reported in immune-deficient patients. In immunocompetent people, M. fortuitum causes human infection primarily by direct inoculation, including localized post-traumatic and surgical wound infections, and catheter-related sepsis. Our patient, an HIV-negative intravenous drug user, had Mycobacterium fortuitum sepsis associated with infective endocarditis, septic pulmonary emboli, and granulomatous hepatitis. Interestingly, the patient admitted using tap water occasionally for mixing heroin when her sterile water ran out, which we thought was the likely source of M. fortuitum. |
| format | Article |
| id | doaj-art-91e88110260b4529b5a17525690229fa |
| institution | Kabale University |
| issn | 2090-6625 2090-6633 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Infectious Diseases |
| spelling | doaj-art-91e88110260b4529b5a17525690229fa2025-02-03T01:10:01ZengWileyCase Reports in Infectious Diseases2090-66252090-66332012-01-01201210.1155/2012/841834841834A Mysterious Gram-Positive RodsJavzandulam Natsag0Zaw Min1Yasir Hamad2Bassel Alkhalil3Atiq Rahman4Richard Williams5Department of Internal Medicine, MedStar Harbor Hospital, 3001 South Hanover Street, Baltimore, MD 21225, USADepartment of Internal Medicine, MedStar Harbor Hospital, 3001 South Hanover Street, Baltimore, MD 21225, USADepartment of Internal Medicine, MedStar Harbor Hospital, 3001 South Hanover Street, Baltimore, MD 21225, USADepartment of Internal Medicine, MedStar Harbor Hospital, 3001 South Hanover Street, Baltimore, MD 21225, USADepartment of Internal Medicine, MedStar Harbor Hospital, 3001 South Hanover Street, Baltimore, MD 21225, USADepartment of Internal Medicine, MedStar Harbor Hospital, 3001 South Hanover Street, Baltimore, MD 21225, USAWe encountered a patient with a history of intravenous drug use presenting with fever, malaise and nausea who was found to have cavitary lung lesions. Unexpectedly, gram positive rods grew out on day five on multiple blood cultures, which were later identified as Mycobacterium fortuitum. The patient underwent transesophageal echocardiogram, which showed aortic and tricuspid valve vegetations. Liver biopsy demonstrated granulomatous hepatitis. Interestingly, serum alkaline phosphatase level fell with antibiotic treatment. Mycobacterium fortuitum is ubiquitous worldwide, being found in tap water, and soil. M. fortuitum is usually considered as a contaminant. Disseminated infection caused by this bacterium in an immunocompetent host is extremely rare. Most of the disseminated infections have been reported in immune-deficient patients. In immunocompetent people, M. fortuitum causes human infection primarily by direct inoculation, including localized post-traumatic and surgical wound infections, and catheter-related sepsis. Our patient, an HIV-negative intravenous drug user, had Mycobacterium fortuitum sepsis associated with infective endocarditis, septic pulmonary emboli, and granulomatous hepatitis. Interestingly, the patient admitted using tap water occasionally for mixing heroin when her sterile water ran out, which we thought was the likely source of M. fortuitum.http://dx.doi.org/10.1155/2012/841834 |
| spellingShingle | Javzandulam Natsag Zaw Min Yasir Hamad Bassel Alkhalil Atiq Rahman Richard Williams A Mysterious Gram-Positive Rods Case Reports in Infectious Diseases |
| title | A Mysterious Gram-Positive Rods |
| title_full | A Mysterious Gram-Positive Rods |
| title_fullStr | A Mysterious Gram-Positive Rods |
| title_full_unstemmed | A Mysterious Gram-Positive Rods |
| title_short | A Mysterious Gram-Positive Rods |
| title_sort | mysterious gram positive rods |
| url | http://dx.doi.org/10.1155/2012/841834 |
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