Community-acquired mastitis due to Mycobacterium abscessus: A case report

Infectious Disease Section, Department of Experimental Medicine and Biochemical Sciences, University of Perugia, Perugia, Italy.
Journal of Medical Case Reports 11/2009; 3(1):130. DOI: 10.1186/1752-1947-3-130
Source: PubMed


Mycobacterium abscessus is a rapidly growing mycobacterium usually causing skin and soft tissue infections in immunocompetent patients following contaminated traumatic or surgical wounds or contaminated injected medications. Disseminated infections and pulmonary infections are usually reported in immunocompromised hosts.
We describe a 54-year-old Caucasian woman with mastitis due to M. abscessus. A few days after clinical evidence of mastitis, the patient was started on broad-spectrum antibiotics. Subsequently, due to persistence of symptoms, a percutaneous breast biopsy was performed followed by surgical drainage. Initial cultures failed to grow micro-organisms and tissue histology showed chronic inflammatory reaction with giant cells. Several days after surgery, her symptoms recurred. Finally, M. abscessus breast infection was diagnosed and the patient was treated successfully.
Rapidly growing mycobacteria need to be included in the differential diagnosis of patients with chronic mastitis having pus discharge and who do not respond to broad-spectrum antibiotics.

Download full-text


Available from: Luigi Maria Lapalorcia
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Mycobacterium abscessus (M. abscessus) is a non-tuberculous mycobacterium and an important emerging pathogen causing skin, soft tissue and pulmonary infections. The case of a 59-year-old man with a history of pulmonary tuberculosis (TB) and current pulmonary infection due to M. abscessus, complicated with pneumocardial disease and bronchiectasis, is described. Zhiel-Neelsen stain and acid Lowenstein-Jensen culture were both positive for acid-fast bacillus. The patient was initially misdiagnosed and ineffectively treated for pulmonary TB. Antimycobacterial susceptibility tests found the isolate to be resistant to four first-line and seven second-line antituberculosis drugs. The isolate was finally identified as M. abscessus using 16S ribosomal RNA and hsp65 and rpoB gene sequence analysis. Species of mycobacterium should be included in the differential diagnosis when patients do not respond to standard antituberculosis therapy. Molecular methods are useful for rapid and species-specific identification.
    Preview · Article · Jun 2011 · The Journal of international medical research
  • [Show abstract] [Hide abstract]
    ABSTRACT: Rapidly growing mycobacteria are pathogens responsible for cutaneous or subcutaneous infections especially occurring after injection, trauma or surgery. We describe a patient with Mycobacterium abscessus mastitis that presented as a mass lesion and haemorrhagical discharge. It was initially diagnosed and treated as fibrocystic disease and non-specific abscess. Full recovery was obtained with combination therapy of clarithromycin, linezolid and amikacin without surgical debridement followed by several abscess aspirations. Atypical mycobacteria should be considered in diagnosis of chronic breast lesions in endemic areas. This is the first reported case of mastitis due to M. abscessus in Turkey.
    No preview · Article · Oct 2011 · Indian journal of medical microbiology