Díaz LO, Fernández ON, Díaz TM, Crespo DT, Valdés QML

Language: Spanish
References: 15
Page: 44-52
PDF size: 191.40 Kb.

ABSTRACT

Introduction: Environmental mycobacteria are organisms broadly distributed in nature, but the diseases they cause are very infrequent. Mycobacterium chelonae is a species from the group of non-pigmented rapidly-growing bacteria causing skin, bone and soft tissue diseases. Pulmonary disease is the least common, and is generally associated to predisposing factors. Its treatment is difficult, due to the high resistance to the antibiotics recommended.
Objective: Describe two cases of infrequent pulmonary infection by Mycobacterium chelonae.
Case presentation: Two cases are presented with a diagnosis of environmental mycobacterial pulmonary infection by Mycobacterium chelonae. Both patients had long febrile periods, coughing, expectoration, difficulty breathing and deterioration of their nutritional status. Case 1 was treated for pulmonary tuberculosis, and both had a history of bronchiectasis. Diagnosis was based on sputum culture supported by imaging techniques in the two cases with fibrocavitary lesions in upper lobes and bronchiectasis. Both patients have undergone several long treatment schemes, but their Mycobacterium chelonae cultures are still positive, and they maintain respiratory symptoms -particularly Case 1-, with deterioration of their overall health status and extensive bilateral lesions.
Conclusions: In the cases presented there was failure of the pharmacological treatment recommended at present, with sustained positive Mycobacterium chelonae sputum cultures. This denotes the complexity of these cases in their pharmacological management, with long, aggressive therapies leading to poor results.

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