Coinfection of Mycobacterium malmoense and Mycobacterium chimaera in a kidney transplant recipient: A case report and review of the literature

Transpl Infect Dis. 2020 Apr;22(2):e13241. doi: 10.1111/tid.13241. Epub 2020 Jan 10.

Abstract

Nontuberculous mycobacteria (NTM) are ubiquitous organisms found in soil and water. Solid organ recipients are at increased risk of NTM infections due to impaired immunity. Although the NTM infections rate is low, it increases morbidity and the risk of mortality. Diagnosis is often delayed because of the lack of specific clinical symptoms and requires a high index of suspicion. Management may be challenging: long-term treatment with risks of side effects and interactions with immunosuppressive regimen; reduction of immunosuppression; and risk of allograft rejection. Prognosis is widely variable. We report the first case of Mycobacterium malmoense chest infection with concomitant Mycobacterium chimaera urinary tract infection in a kidney transplant recipient. The evolution was marked by poor tolerance of the treatment with severe adverse events and disabled functional status.

Keywords: Mycobacterium chimaera; Mycobacterium malmoense; kidney transplantation; nontuberculous mycobacteria; solid organ transplant.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Coinfection / diagnosis*
  • Coinfection / microbiology*
  • Humans
  • Immunosuppression Therapy
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Mycobacterium / isolation & purification*
  • Mycobacterium Infections, Nontuberculous / diagnostic imaging
  • Mycobacterium Infections, Nontuberculous / microbiology
  • Positron Emission Tomography Computed Tomography
  • Respiratory Tract Infections / diagnosis
  • Respiratory Tract Infections / microbiology
  • Urinary Tract Infections / diagnosis
  • Urinary Tract Infections / microbiology

Supplementary concepts

  • Mycobacterium chimaera
  • Mycobacterium malmoense