Pulmonary Mycobacterium kyorinense disease: A case report and review of literature

Indian J Med Microbiol. 2019 Jan-Mar;37(1):127-131. doi: 10.4103/ijmm.IJMM_19_94.

Abstract

We report here the first case of pulmonary infection due to Mycobacterium kyorinense in a 55-year-old hypertensive woman treated for pulmonary tuberculosis earlier on two occasions. She presented with productive cough, intermittent episode of left-sided chest pain, loss of appetite, low-grade fever, and breathlessness. Sputum cultures revealed non-tuberculous mycobacteria (NTM). She remained persistently symptomatic with sputum cultures positive for acid-fast bacilli even after 6 months of treatment. Hence, a 16SrRNA gene amplification and sequencing were done that revealed M. kyorinense. Based on the guidelines of the American Thoracic Society, she was started on weight-based dosing of clarithromycin, levofloxacin, ethambutol, isoniazid and injection amikacin daily. The patient improved symptomatically and became culture-negative after 3 months of therapy with the above regimen and continued to be culture negative for 12 months of treatment. She continues to remain symptom-free without evidence of any clinical or bacteriological relapse.

Keywords: 16SrRNA; non-tuberculous mycobacteria; rifampicin resistance.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Amikacin / therapeutic use
  • Antitubercular Agents / therapeutic use*
  • Clarithromycin / therapeutic use
  • Ethambutol / therapeutic use
  • Female
  • Humans
  • Isoniazid / therapeutic use
  • Levofloxacin / therapeutic use
  • Middle Aged
  • Mycobacterium / genetics*
  • Mycobacterium / isolation & purification
  • Mycobacterium Infections, Nontuberculous / diagnosis*
  • Mycobacterium Infections, Nontuberculous / drug therapy*
  • Mycobacterium Infections, Nontuberculous / microbiology
  • RNA, Ribosomal, 16S / genetics
  • Respiratory Tract Infections / diagnosis*
  • Respiratory Tract Infections / drug therapy
  • Respiratory Tract Infections / microbiology

Substances

  • Antitubercular Agents
  • RNA, Ribosomal, 16S
  • Levofloxacin
  • Amikacin
  • Ethambutol
  • Clarithromycin
  • Isoniazid

Supplementary concepts

  • Mycobacterium kyorinense