What the less common sites for mycobacterium chelonae infection?

Updated: Dec 20, 2018
  • Author: Alfred Scott Lea, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Pulmonary disease with M chelonae is uncommon, and other atypical mycobacteria such as M avium complex (MAC), M kansasii, and M abscessus are the more likely lung pathogens. [24] When M chelonae has been described as the causative pathogen, it usually occurs in patients with severe underlying lung disease such as cystic fibrosis or bronchiectasis, patients with significant gastroesophageal disorders, or in patients with signs of connective-tissue disorders such as mitral valve prolapse (MVP), scoliosis, and pectus excavatum. [25]

Musculoskeletal involvement with M chelonae is also uncommon, but is associated with penetrating trauma. Both osteomyelitis and granulomatous tenosynovitis have been reported without any known preceding trauma. [12, 26] Prosthetic joint infections with M chelonae have been described. [27]

Sinusitis and otitis media secondary to M chelonae has been reported. [28] Cases associated with prior surgery, topical corticosteroid usage, and pressure equalization (PE) tube insertion have been described. [18, 29] M abscessus is the more likely atypical organism to cause otitis media.

Bacteremia is usually associated with fever, with or without chills and sweats. Shock and multisystem organ failure is unusual. Patients typically possess intravascular catheters, dialysis catheters, biliary stents, or prosthetic heart valves and are usually immunocompromised.

Immune defects such as autoantibodies to specific interleukins (ILs), interferon-gamma (INF-γ), and IL or INF receptor deficiencies have been reported and are risk factors for disseminated NTM, in addition to known risk factors such as HIV infection, long-term steroid use, immunosuppressives, and TNF-α inhibitors. [25, 29, 30]


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