Mycobacterium Chelonae Developing Multidrug Resistance

BMJ Case Rep. 2018 Feb 22:2018:bcr2017222569. doi: 10.1136/bcr-2017-222569.

Abstract

Mycobacterium chelonae is a rapidly growing mycobacterium which is known to respond well to standard antibiotic treatment regimen. There are no specific guidelines for treatment. Antibiotics are chosen based on the bacterial sensitivity. Here we present a 47-year-old man with hip replacement who developed bright red papular generalised skin lesions and bilateral hip abscess. On workup, it was confirmed that M. chelonae was the causative organism. He was given 8 weeks of antibiotics; however, there was worsening of the hip abscess on interval imaging. The progression was most likely due to M. chelonae developing antibiotic resistance. Physicians should be aware of the rising resistance of this organism, and guide antibiotic therapy based on bacterial sensitivity to yield better outcomes.

Keywords: drugs: infectious diseases; infections.

Publication types

  • Case Reports

MeSH terms

  • Abscess / drug therapy
  • Amikacin / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Arthroplasty, Replacement, Hip*
  • Azithromycin / therapeutic use
  • Drug Resistance, Multiple, Bacterial*
  • Hip Joint / microbiology*
  • Humans
  • Male
  • Middle Aged
  • Minocycline / analogs & derivatives
  • Minocycline / therapeutic use
  • Mycobacterium Infections, Nontuberculous / drug therapy*
  • Mycobacterium chelonae / isolation & purification*
  • Skin Diseases, Bacterial / drug therapy*
  • Tigecycline

Substances

  • Anti-Bacterial Agents
  • Tigecycline
  • Azithromycin
  • Amikacin
  • Minocycline