A very rare case of mycobacterium gordonae infection of the breast

Pamparino, Silvia; Valente, Irene; Tagliafico, Alberto; Dentone, Chiara; Bassetti, Matteo; Mennella, Simone; Calabrese, Massimo; Garlaschi, Alessandro

doi:10.1111/tbj.14086

Cited by 6 publications

(2 citation statements)

References 12 publications

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“…M. chelonae is a rapidly growing NTM that usually only causes infections in patients with trauma or immunodeficiencies [ 1 ]. Although NTM causes mastitis in bovines and goats, it rarely does so in humans [ 6 – 10 ]. There are very few reports of breast abscesses caused by M. chelonae following breast augmentation or reduction mammoplasty [ 2 – 5 ].…”

Section: Discussionmentioning

confidence: 99%

A rare spontaneous breast abscess due to Mycobacterium chelonae: a case report

2023

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Background Mycobacterium chelonae, a nontuberculous mycobacterium, commonly causes skin, soft tissue, eye, pulmonary, catheter-related, and post-surgical infections in patients with immunosuppression or trauma. M. chelonae breast infections are rare, and most cases occur following cosmetic surgery. Here, we report the first case of spontaneous breast abscess due to M. chelonae. Case presentation A 22-year-old Japanese woman presented at our hospital with swelling and pain in the right breast for the past 2 weeks without any fever. She had a 19-month-old child and stopped breastfeeding 1 month after giving birth. The patient had no history of trauma or breast surgeries, no family history of breast cancer, and was not immunocompromised. Breast ultrasonography revealed a heterogeneous hypoechoic lesion with multiple fluid-filled areas suspected to be abscesses. Dynamic contrast-enhanced magnetic resonance imaging revealed a 64 × 58 × 62 mm, ill-defined, high-signal-intensity lesion with multiple ring enhancements in the upper half of the right breast. The first diagnosis was inflammatory breast cancer or granulomatous mastitis with abscess. A core needle biopsy led to drainage of pus. Gram staining did not reveal any bacteria in the pus, but the colonies from the biopsy grew on blood and chocolate agar cultures. Mass spectrometry detected M. chelonae in these colonies. Histopathological findings revealed mastitis without malignancy. The patient's treatment regimen was oral clarithromycin (CAM) based on susceptibility. Three weeks later, although the pus had reduced, the induration in the breast did not resolve; therefore, multidrug antibiotic treatment was initiated. The patient received amikacin and imipenem infusion therapy for 2 weeks, followed by continuation of CAM. Three weeks later, tenderness in the right breast recurred with slight pus discharge. Hence, minocycline (MINO) was added to the treatment. The patient stopped CAM and MINO treatment 2 weeks later. There was no recurrence 2 years after treatment. Conclusion We report a case of M. chelonae breast infection and abscess formation in a 22-year-old Japanese woman without obvious risk factors. M. chelonae infection should be considered in cases of intractable breast abscess, even in patients without immunosuppression or trauma.

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Section: Discussionmentioning

confidence: 99%

A rare spontaneous breast abscess due to Mycobacterium chelonae: a case report

2023

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“…Potentially all NTM species can cause skin infections; however, for the slow growing mycobacterium (SGM) M. marinum , the skin is the typical site of infection, and the rapidly growing mycobacteria (RGM) M. fortuitum , M. abscessus and M. chelonae may also give cutaneous disease. MAC complex [ 44 ] and less pathogenic NTM may also determine SSTIs, as reported for M. haemophilum [ 7 , 45 , 46 ], M. gordonae [ 47 ] and M. agri [ 48 ].…”

Section: Mycobacterial Skin Infectionsmentioning

confidence: 99%

Mycobacterial skin infection

Giannotti

Gregori

Matteelli

et al. 2022

Current Opinion in Infectious Diseases

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Purpose of review The aim of this article is to review the most recent evidences concerning mycobacterial skin infections, limiting the period of literature research to 2020--2021. Recent findings Mycobacterial skin infections include a heterogeneous group of cutaneous diseases. Cutaneous tuberculosis is usually the result of hematogenous dissemination or spread from underlying foci and it must be distinguished from tuberculids, resulting from the immunological reaction to Mycobacterium tuberculosis antigens. Leprosy prevalence was drastically reduced after introduction of multidrug therapy in the 1980 s, but cases are still reported due to underdiagnosis, and animal and environmental reservoirs. Recent advances concentrate in the diagnostic field. Specific guidelines for the treatment of nontuberculous mycobacteria skin infections are missing and surgical procedures may be required. Prognosis is better as compared to nontuberculous mycobacteria lung disease. Rapid laboratory-confirmed diagnosis of Buruli ulcer may be achieved by the IS2404 PCR. Among new drugs, telacebec is promising in terms of potency, shorter duration and tolerability in animal studies. A clinical trial in humans is planned. Summary Mycobacterial cutaneous lesions are nonpathognomonic and clinical suspicion must be confirmed by culture or molecular detection. Long-course multidrug treatment is required based on susceptibility tests. Surgical intervention may also be required. Rehabilitation and psychosocial support reduce long-term physical and mental consequences mostly in Buruli ulcer and leprosy.

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