Two case reports: The successful management of pulmonary mycobacterium bohemicum

We describe two successfully managed cases from Dumfries and Galloway, West of Scotland. The first was a 62 years old male who previously worked as an ambulance paramedic with a background history of Chronic Obstructive Pulmonary Disease (COPD) and both Mitral and Aortic (non-mechanical) repair. Chest Xray showed features of bronchiectasis and bilateral atlectasis. Sputum was smear negative however extended culture grew M. bohemicum after 12 weeks. This was reported to be resistant to Clarithromycin and Rifabutin. As this was a single isolate from a non sterile site and the patient was asymptomatic, no treatment was started. The Second was an 83 years old gentleman with a background history of COPD, Chronic Kidney Disease and smoking who was treated for right lung consolidation. Sputum was smear positive and the patient was initially treated as Mycobacaterium Tuberculosis with Rifater, however, Polymerase Chain Reaction confirmed the organism to be NTM. Treatment regime was changed to Rifampicin, ethambutol and clarithromycin. Cultures grew M. bohemicum after a few weeks sensitive to Rifampicin, Clarithromycin and Rifabutin but resistant to Ethambutol and Ciprofloxacin. Further cultures grew M. malmoense 4 months later. The patient finished 1 year of treatment with clinical improvement and no side effect. M. bohemicum is a new NTM with little data on its successful management only nine extra-pulmonary infections have been documented in the literature and one pulmonary that le...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: 10.2 Tuberculosis Source Type: research