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Successful Antibiotic Treatment of Mycobacterium abscessus Pulmonary Disease in an Immunocompetent Individual | OMICS International | Abstract

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Case Report

Successful Antibiotic Treatment of Mycobacterium abscessus Pulmonary Disease in an Immunocompetent Individual

Anna Beltrame1* Giovanni Cattani1 Federica Brillo1 Maria Merelli1 Claudio Scarparo2 Giuseppe Como3 Maria Consuelo Screm2 Tortoli4 Alberto Matteell5
1Clinic of Infectious Diseases, S.M. Misericordia University Hospital, P.le S.M. Misericordia 15, 33100 Udine, Italy
2Microbiology Department, S.M. Misericordia University Hospital, Udine, Italy
3Institute of Diagnostic Radiology, S.M. Misericordia University Hospital, Udine, Italy
4Regional Reference Center for Mycobacteria, Microbiology and Virology Laboratory, Careggi University Hospital, Firenze, Italy
5Institute of Infectious and Tropical Diseases, Spedali Civili University Hospital, Brescia, Italy
Corresponding Author : Anna Beltrame
Clinic of Infectious Diseases
S.M. Misericordia University Hospital
P.le S.M. Misericordia 15
33100 Udine, Italy
Tel: +39.0432 559354
Fax: +39.0432 559360
Received March 18, 2013; Accepted April 08, 2013; Published April 13, 2013
Citation: Beltrame A, Cattani G, Screm MC, Brillo F, Merelli M, et al. (2013) Successful Antibiotic Treatment of Mycobacterium abscessus Pulmonary Disease in an Immunocompetent Individual. J Infect Dis Ther 1:103. doi:10.4172/2332-0877.1000103
Copyright: © 2013 Beltrame A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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 The number of subjects with Mycobacterium abscessus lung disease is increasing. The optimal treatment to prevent clinical relapse in these patients has not been well established. At times, antibiotic regimens have also been shown to produce long-term sputum conversion. We describe a case of M. abscessus  lung disease in an immunocompetent individual with successful outcome at 24 months, following antibiotic therapy. Initially, an empirical treatment was started intravenously with amikacin (700 mg once-daily), cefoxitin (4 g every 8 h), and oral clarithromycin (500 mg twice daily). Although, the symptoms resolved rapidly, the anti-mycobacterial drugs were discontinued three weeks later, following the onset of hepatotoxicity. Two weeks after discontinuation of therapy, the liver enzymes were returned to normal levels, and amikacin and clarithromycin were reintroduced and continued for another 8 months, when the individual developed hearing loss, which led to further discontinuation of antibiotic therapy. During the subsequent 24 months, broncoscopy, sputum AFB examination and mycobacterial culture were negative. Our management suggests that prompt, individualized and protracted treatment can be curative, in case of mild disease.