A Case Report of Mycobacterium Abscessus Septicemia Due to Chemoport Infection / 감염

ABSTRACT

Mycobacterium abscessus, a rapidly growing mycobacterium, is an opportunistic pathogen which causes a wide variety of clinical symptoms. Recently non-tuberculous mycobacterial infections are increasing among immunocompromised patients and made 4% of total cases of mycobacterial infection. To our knowledge, there has been no report of systemic infection caused by rapidly growing mycobacterium in Korea. We experienced a case of M. abscessus septicemia due to chemoport infection in a 47-year old female who was diagnosed as ovarian cancer stage IIIc and was in the immunocompromised state after systemic chemotherapy. The patient manifested with fever, chilling, headache, and nausea, though, there were no abnormalities on physical examination. When the patient was receiving empirical antibiotic therapy, a rapidly growing mycobacterium was detected in repeated blood cultures. She was improved with not only systemic an-tibiotic treatment but also removing the chemoport. But short course (4 weeks) of antibiotic therapy caused incomplete treatment and made multiple skin abscess. After incision and drainage of the lesions and administration of prolonged antibiotic therapy, no additional infection was observed. Based on our experience and the review of the literatures, catheter-related bacteremia due to rapidly growing mycobacterium, including M. abscessus, should be treated with catheter removal and appropriate antibiotic therapy for at least 3 to 6 months based on in vitro susceptibility testing. When a patient in neutropenic state presents sustained fever after treatment with conventional antibiotics, non-tuberculous mycobacterial infection should be considered.