Pneumonia due to Mycobacterium cosmeticum in a renal transplant recipient

BMJ Case Rep. 2021 Mar 2;14(3):e234800. doi: 10.1136/bcr-2020-234800.

Abstract

A 69-year-old man renal transplant recipient for 4 years, presented with 4-day history of cough and dyspnoea. He was diagnosed with community-acquired pneumonia and treated accordingly. He deteriorated requiring intensive care unit admission and intubation. Mycobacterial culture from bronchoalveolar lavage grew colonies within 7 days of incubation while Mycobacterium tuberculosis PCR was negative. The antibiotic regimen was adjusted to cover for rapidly growing mycobacteria with imipenem, amikacin and clarithromycin. The final culture reported Mycobacterium cosmeticum He improved on the antibiotic regimen given which the organism turned to be sensitive to. We reported the second case with M. cosmeticum that fulfilled the diagnostic criteria for non-tuberculous mycobacterial lung infection. Improvement of patient's lung infection on appropriate antibiotics points to a causal relationship.

Keywords: pneumonia (respiratory medicine); renal transplantation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amikacin
  • Clarithromycin / therapeutic use
  • Humans
  • Kidney Transplantation* / adverse effects
  • Male
  • Mycobacteriaceae
  • Mycobacterium Infections, Nontuberculous* / diagnosis
  • Mycobacterium Infections, Nontuberculous* / drug therapy

Substances

  • Amikacin
  • Clarithromycin

Supplementary concepts

  • Mycolicibacterium cosmeticum