Hyperammonemia in Generalized Mycobacterium genavense Infection after Renal Transplantation

Nurmohamed, Shaikh A.; Weenink, A.; Moeniralam, Hazra S.; Visser, Caroline E.; Bemelman, F. J.

doi:10.1111/j.1600-6143.2006.01680.x

Cited by 42 publications

(38 citation statements)

References 10 publications

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“…2,6,8 Hence, M. genavense diagnosis remains challenging owing to the difficulty in obtaining cultures, even over prolonged times, 2 and their frequency is probably underestimated. Because of the life-threatening character of M. genavense infection and difficulties in identifying this mycobacterium by standard culture, clinicians must be aware of the need for nucleic acid-based identification techniques for diagnosis of M. genavense infection in transplant recipients.…”

Section: Discussionmentioning

confidence: 99%

“…Disseminated infection with Mycobacterium genavense has been described mostly in patients with advanced human immunodeficiency virus (HIV) infection. 1 In HIV-negative patients, about 10 reports of disseminated M. genavense infection have been published in immunocompromised hosts, [2][3][4][5][6][7][8][9][10] including only 4 cases have occurred in transplant recipients in the last 5 years. 2,[6][7][8] We report a case in a lung transplant recipient, with a fatal outcome more than 3 years after a diagnosis owing to late-onset recurrence of the infection.…”

Section: Introductionmentioning

confidence: 99%

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Relapsing Mycobacterium Genavense Infection as a Cause of Late Death in a Lung Transplant Recipient: Case Report and Review of the Literature

Lhuillier¹,

Brugière²,

Véziris³

et al. 2012

Exp Clin Transplant

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Mycobacterium genavense is recognized as a lifethreatening pathogen in severely immunocompromised patients, mostly in those with advanced human immunodeficiency virus infection. We report a case of M. genavense infection in a lung-transplant recipient with late-onset death occurring from disseminated infection. In human immunodeficiency virus-negative patients, there exist only about 10 reports of disseminated M. genavense infection in immunocompromised hosts; and to our knowledge, this is a first reported case of M. genavense infection after a lung transplant. Diagnosis of M. genavense was obtained only with nucleic acid-based identification technique, as frequently observed in a few cases of human immunodeficiency virus-negative patients. A striking feature was the recurrence of this infection in our patient after a seemingly infection-free period of 3 years. Because M. genavense infection can be life-threatening, clinicians must be aware of the frequent requirement for nucleic-acid-based identification for its diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Relapsing Mycobacterium Genavense Infection as a Cause of Late Death in a Lung Transplant Recipient: Case Report and Review of the Literature

Lhuillier¹,

Brugière²,

Véziris³

et al. 2012

Exp Clin Transplant

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“…Causative NTM species described in disseminated disease are M. chelonae and M. abscessus. Finally, M. haemophilum and M. genavense can rarely cause disseminated disease in SOT recipients [22,24,[30][31][32], which may also include unusual manifestations such as intestinal involvement [25].…”

Section: Clinical Presentationmentioning

confidence: 99%

Nontuberculous mycobacteria infection in solid organ transplant recipients

Piersimoni¹

2011

Eur J Clin Microbiol Infect Dis

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Although advances in surgical technique, drug-induced immunosuppression, and supportive medical therapy have led to improved survival and quality of live after solid organ transplantations, infections still represent a major threat for transplant recipients.Infections with non tuberculous mycobacteria (NTM) are infrequent, but can be associated with relevant morbidity and mortality. With the exception of few comprehensive studies, the available literature consists predominantly of case reports and institutional experiences. This article reviews NTM infection in the setting of solid organ transplant (SOT) recipients dealing with clinical features, diagnosis, treatment and outcome. Published studies have documented a protean presentation of NTM infection in SOT recipients which may include skin and soft tissue lesions, osteoarticular infections and pleuropulmonary disease. An aggressive approach including histopathologic examination and acid-fast bacilli culture of aspirates or biopsy specimens from involved sites are essential for diagnosis. A combined treatment of debridement surgery, reduction of immunosuppressive medications and/or antimycobacterial drugs is frequently associated with a favorable outcome. It is strongly emphasized that a high index of suspicion for NTM infection should be maintained when managing SOT recipients with unusual clinical manifestations. Early diagnosis and initiation of therapy are essential to prevent morbidity and mortality in this vulnerable population.

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“…Secondary dissemination occurred in one case. M. genavense infection has previously been reported in only two solid organ (kidney and heart) transplanted patients [10,11]. Both had intestinal involvement leading to secondary dissemination and death in one case [10].…”

Section: Discussionmentioning

confidence: 99%

Mycobacterium genavense as a cause of subacute pneumonia in patients with severe cellular immunodeficiency

et al. 2011

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BackgroundMycobacterium genavense is a rare nontuberculous mycobacteria (NTM). Human infections are mostly disseminated in the setting of the AIDS epidemic or the use of aggressive immunosuppressive treatments. M. genavense culture is fastidious, requiring supplemented media. Pulmonary involvement rarely occurs as a primary localization.Cases presentationWe report here two patients with pneumonia as the predominant manifestation of M. genavense infection: one kidney transplanted patient and one HIV-infected patient. Both patients were initially treated with anti-tuberculous drugs before the identification of M. genavense on sputum or broncho-alveolar lavage fluid culture. A four-drug regimen including clarithromycin and rifabutin was started. Gamma interferon has been helpful in addition to antimycobacterial treatment for one patient.ConclusionClinicians should be aware that M. genavense could be the etiologic agent of sub-acute pneumonia mimicking tuberculosis in patients with cellular immunodeficiency status.

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Hyperammonemia in Generalized Mycobacterium genavense Infection after Renal Transplantation

Cited by 42 publications

References 10 publications

Relapsing Mycobacterium Genavense Infection as a Cause of Late Death in a Lung Transplant Recipient: Case Report and Review of the Literature

Relapsing Mycobacterium Genavense Infection as a Cause of Late Death in a Lung Transplant Recipient: Case Report and Review of the Literature

Nontuberculous mycobacteria infection in solid organ transplant recipients

Mycobacterium genavense as a cause of subacute pneumonia in patients with severe cellular immunodeficiency

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