Pulmonary Infection due to Mycobacterium xenopi.

Abstract

Wedescribe two cases of pulmonary infection due to Mycobacteriumxenopi (M. xenopi). Both cases were men, ages 61 and 54 yr. In the first patient, lung infection due toAf. xenopi occurred after gastrectomy. The second patient had an inactive M. tuberculosis infection. Both had pulmonary symptoms including cough, sputum and fever. Each chest X-ray showed an infiltrative shadow with a cavity in a unilateral, upper lobe. Isolates from both patients were studied not only by microbiological characteristics but also by DNA-DNA hybridization. All isolates were susceptible to streptomycin and kanamycin. In the first case, the patient had initially received rifampicin, isoniazid and ethambutol despite in vitro susceptibility patterns, however, there was no response and a new infiltrative shadow appeared in the contralateral lobe. With a multiple drug regimen based on in vitro susceptibility, clinical and roentgenographic improvements were achieved. The second patient showed a favorable response to the initial chemotherapy. Pulmonary infection due to M. xenopi can generally be successfully treated with drugs to which the organisms show in vitro sensitivity. Wealso reviewed the other two cases reported in Japan. (Internal Medicine 33: 536-539, 1994)

Successful Treatment of PulmonaryMycobacterium xenopiInfection in a Natural Killer Cell–Deficient Patient with Clarithromycin, Rifabutin, and Sparfloxacin

“…Chemotherapeutic combination protocols with three to four drugs and an overall treatment duration of 18 -24 months usually are recommended in cases of M. xenopi infection [1,5,[12][13][14][15][16]. On the basis of results of vitro susceptibility testing, we selected a combination of clarithromycin, rifabutin, and sparfloxacin for therapy.…”

Emerging pathology: Pulmonary disease caused by Mycobacterium xenopi - a challenge in clinical practice

“…In 1994, Terashima et al 23 reported two cases of pulmonary disease caused by M. xenopi -one occurred after gastrectomy and the other synchronously with M. tuberculosis infection, both presented with features of an infectious disease and unilateral cavitary lesion at chest x-rays 23 . Several cases of Japanese authors have been reported thereafter 22,24 .…”

Differential requirement for interferon-γto restrict the growth of or eliminate some recently identified species of nontuberculous mycobacteriain vivo

“…Other species recovered with relative frequency are M. xenopi and M. malmoense which primarily cause pulmonary disease and lymphadenitis, respectively [9,10]. In addition, due to improved culture techniques and the more wide-spread use of 16SrRNA-sequencing for diagnostic purposes [11], an increasing number of previously unrecognized species have recently been identified from clinical sources.…”