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Case report
Mycobaterium fortuitum disseminated infection in an immunocompetent patient without predisposing factors
  1. Stephanie d'Incau1,
  2. Maria-Isabel Vargas2,
  3. Alexandra Calmy3 and
  4. Jean-Paul Janssens4
  1. 1Division of Infectious Diseases, Inselspital University Hospital Bern, Bern, Switzerland
  2. 2Neuroradiology, Geneva University Hospitals, Geneva, Switzerland
  3. 3HIV/AIDS Unit, Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
  4. 4Division of Pulmonology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
  1. Correspondence to Dr Stephanie d'Incau; stephanie.dincau{at}insel.ch

Abstract

Most Mycobacterium fortuitum infections described involve direct inoculation through skin lesions. We describe the case of a patient without risk factors who presented with an intracranial mass and a pulmonary infection with M. fortuitum. As M. fortuitum are rarely pathogens, there is little knowledge about the optimal treatment and outcome of such infections: what is the best mode of administration, what is the best therapy duration and is surgery always required are some of the unanswered questions. In our patient, surgical removal of the mass associated with a 1-year antimycobacterial therapy led to a full recovery. Even though M. fortuitum was rapidly identified in sputum, it was initially considered non-pathogenic and the definitive diagnosis required almost 6 weeks of investigations. New molecular techniques will probably lead to more identifications of M. fortuitum in the next few years and a better knowledge of their possible pathogenicity and optimal treatment.

  • infectious diseases
  • infection (neurology)
  • respiratory medicine
  • TB and other respiratory infections
  • radiology
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Footnotes

  • Contributors Sd: design and conceptualisation of the case report, involved in clinical care, acquisition of data, analysis and interpretation of data, drafting of manuscript. M-IV: involved in interpretation of CT scan and MRI, revision of manuscript for intellectual content. AC and J-PJ: involved in clinical care, acquisition of data, analysis and interpretation of data, revision of manuscript for intellectual content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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