Successful Treatment of Mycobacterium celatum Pulmonary Disease in an Immunocompetent Patient Using Antimicobacterial Chemotherapy and Combined Pulmonary Resection

Mycobacterium celatum is a nontuberculous mycobacterium that rarely causes pulmonary disease in immunocompetent subjects. We describe the successful treatment of M. celatum lung disease with antimicobacterial chemotherapy and combined pulmonary resection. A 33-year-old woman was referred to our hospital with a 3-month history of a productive cough. Her medical history included pulmonary tuberculosis 14 years earlier. Her chest X-ray revealed a large cavitary lesion in the left upper lobe. The sputum smear was positive for acid-fast bacilli, and M. celatum was subsequently identified in more than three sputum cultures, using molecular methods. After 1 year of therapy with clarithromycin, ethambutol, and ciprofloxacin, the patient underwent a pulmonary resection for a persistent cavitary lesion. The patient was considered cured after receiving 12 months of postoperative antimycobacterial chemotherapy. There has been no recurrence of disease for 18 months after treatment completion. In summary, M. celatum is an infrequent cause of potentially treatable pulmonary disease in immunocompetent subjects. Patients with M. celatum pulmonary disease who can tolerate resectional surgery might be considered for surgery, especially in cases of persistent cavitary lesions despite antimycobacterial chemotherapy.

Pulmonary infection with Mycobacterium celatum in immunocompetent host: The first case report in Korea / 결핵

Mycobacterium celatum is a recently described nontuberculous mycobacterium. Even though pulmonary or lymphatic infection cases were reported previously in human, the clinical significance of the infection with M.celatum is not yet understood completely. Most infections with this species occurred in the patients with suppressed cell-mediated immunity such as AIDS, and there are only a few cases of pulmonary infection with M.celatum in immunocompetent adults or infants in the world. In Korea, mycobacterial pulmonary infection is a major problem of respiratory disease but, there has been no pulmonary infection with M. celatum reported. We report, to our knowledge, the first Korean case of pulmonary infection with M. celatum, which was identified by gamma poB genomic sequencing.