Mycobacterium abscessus infection in a burn intensive care unit patient

Tanaz Vaghaiwalla, Shevonne S. Satahoo, Rolla Zarifa, Marc Dauer, James S. Davis, Doreann Dearmas, Nicholas Namias, Louis R Pizano, Carl I Schulman

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Infection is the leading cause of death in burn patients. Historically, this was due to burn wound sepsis but pneumonia has now emerged as the most common source. In light of the increasing incidence of multi-drug-resistant organisms, the description of rare infections is paramount in continuing the fight against deadly pathogens. We aim to describe the second case of non-tuberculous mycobacterium (NTM) reported in a burn patient. Difficulties in diagnosis and management will also be highlighted. Methods: A 70-y-old Caucasian female, with a past medical history for type 2 diabetes mellitus, was transferred to our facility after a house fire. She had sustained a 28% total body surface area (TBSA) flame burn to her neck, torso, and all four extremities. She underwent excision and grafting on hospital day five with multiple subsequent attempts at excision and grafting due to graft loss. On hospital day 14, a tracheostomy was performed. Her hospital course was complicated by ongoing respiratory failure, renal injury, and sepsis. Results: Mycobacterium abscessus was found on blood cultures from central venous catheters and arterial line catheters as well as on tracheal aspirate and bronchoalveolar lavage (BAL) on hospital day 86. Imaging then revealed multiple pulmonary nodular densities with patchy ground-glass opacities. After multiple adjustments to the antibiotic regimen, tigecycline, clarithromycin, and cefoxitin therapy was started. She remained on this regimen for almost 4wks. Her other infections included Acinetobacter baumanii treated with tobramycin and colistin, as well as Candida albicans for which she received fluconazole. Ultimately, her clinical state worsened leading to withdrawal of care. Conclusions: Sepsis NTM is rare in burn patients with only one other case described in the English-language literature. Both cases reflect differences in diagnosis and management. This highlights the need to discuss rare infections in an attempt to broaden the clinician's awareness of such pathogens, as well as to collaborate to form a consensus about their management.

Original languageEnglish
Pages (from-to)847-849
Number of pages3
JournalSurgical Infections
Volume15
Issue number6
DOIs
StatePublished - Jan 1 2014

Fingerprint

Mycobacterium Infections
Intensive Care Units
Mycobacterium
Sepsis
Acinetobacter Infections
Infection
Colistin
Social Adjustment
Cefoxitin
Torso
Vascular Access Devices
Tobramycin
Clarithromycin
Central Venous Catheters
Fluconazole
Tracheostomy
Body Surface Area
Wounds and Injuries
Bronchoalveolar Lavage
Candida albicans

ASJC Scopus subject areas

  • Surgery
  • Infectious Diseases
  • Microbiology (medical)

Cite this

Vaghaiwalla, T., Satahoo, S. S., Zarifa, R., Dauer, M., Davis, J. S., Dearmas, D., ... Schulman, C. I. (2014). Mycobacterium abscessus infection in a burn intensive care unit patient. Surgical Infections, 15(6), 847-849. https://doi.org/10.1089/sur.2014.052

Mycobacterium abscessus infection in a burn intensive care unit patient. / Vaghaiwalla, Tanaz; Satahoo, Shevonne S.; Zarifa, Rolla; Dauer, Marc; Davis, James S.; Dearmas, Doreann; Namias, Nicholas; Pizano, Louis R; Schulman, Carl I.

In: Surgical Infections, Vol. 15, No. 6, 01.01.2014, p. 847-849.

Research output: Contribution to journalArticle

Vaghaiwalla, T, Satahoo, SS, Zarifa, R, Dauer, M, Davis, JS, Dearmas, D, Namias, N, Pizano, LR & Schulman, CI 2014, 'Mycobacterium abscessus infection in a burn intensive care unit patient', Surgical Infections, vol. 15, no. 6, pp. 847-849. https://doi.org/10.1089/sur.2014.052
Vaghaiwalla T, Satahoo SS, Zarifa R, Dauer M, Davis JS, Dearmas D et al. Mycobacterium abscessus infection in a burn intensive care unit patient. Surgical Infections. 2014 Jan 1;15(6):847-849. https://doi.org/10.1089/sur.2014.052
Vaghaiwalla, Tanaz ; Satahoo, Shevonne S. ; Zarifa, Rolla ; Dauer, Marc ; Davis, James S. ; Dearmas, Doreann ; Namias, Nicholas ; Pizano, Louis R ; Schulman, Carl I. / Mycobacterium abscessus infection in a burn intensive care unit patient. In: Surgical Infections. 2014 ; Vol. 15, No. 6. pp. 847-849.
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