Title

Case Report of a Near-fatal Case of Mycobacterium massiliense Sepsis after De-clotting of an Arteriovenous Fistula

Division

East Florida

Hospital

Westside Regional Medical Center

Document Type

Case Report

Publication Date

12-1-2021

Keywords

Mycobacterium massiliense, sepsis, arteriovenous fistula

Disciplines

Bacterial Infections and Mycoses | Internal Medicine | Therapeutics

Abstract

Background

Mycobacterium massiliense is a rapidly growing a non-tuberculous mycobacterium that has been validated as a separate species from the Mycobacterium abscessus group. Only few antibiotics have demonstrated germicidal activity against Mycobacterium massiliense, and some of those include amikacin, clarithromycin, and cefoxitin.

Case presentation

We present the first reported case of near-fatal septic shock caused by disseminated Mycobacterium massiliense after de-clotting of an infected arteriovenous fistula, in a patient with end-stage renal disease with concomitant human immunodeficiency virus infection. Early recognition of the culprit organism and treatment with a combination therapy of clarithromycin and amikacin led to rapid improvement.

Conclusion

This unique case can highlight the importance of taking into consideration Mycobacterium massiliense infection as a cause of arteriovenous fistula thrombosis and highlights the risk of disseminated infection leading to life threatening sepsis upon de-clotting of the fistula.

Publisher or Conference

The Egyptian Journal of Internal Medicine

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