Pulmonary disease caused by a newly identified mycobacterium: Mycolicibacterium toneyamachuris : a case report
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CASE REPORT
Open Access
Pulmonary disease caused by a newly identified mycobacterium: Mycolicibacterium toneyamachuris: a case report Tomoki Kuge1, Kiyoharu Fukushima1,2,3* , Yuki Matsumoto4, Yuko Abe2, Eri Akiba1, Kako Haduki1, Haruko Saito1, Tadayoshi Nitta1, Akira Kawano1, Takahiro Kawasaki1, Takanori Matsuki1, Hiroyuki Kagawa1, Daisuke Motooka4, Kazuyuki Tsujino1, Mari Miki1, Keisuke Miki1, Seigo Kitada5, Shota Nakamura4, Tetsuya Iida4 and Hiroshi Kida1
Abstract Background: Non-tuberculous mycobacterial pulmonary disease (NTM-PD) is becoming a significant health burden. Recent advances in analysis techniques have allowed the accurate identification of previously unknown NTM species. Here, we report a case of NTM-PD caused by a newly identified mycobacteria in an immunocompetent patient. Case presentation: A 44-year-old woman was referred to our hospital due to the frequent aggravation of her chronic respiratory symptoms, with NTM-PD-compatible computed tomography findings. Unidentified mycobacterium was repeatedly isolated from respiratory specimens and we diagnosed her as NTM-PD of unidentified mycobacterium. Subsequent whole-genome analysis revealed that the unidentified mycobacterium was a novel mycobacterium genetically close to Mycolicibacterium mucogenicum. We started combination therapy with clarithromycin, moxifloxacin, amikacin, and imipenem/cilastatin, referring to drug sensitivity test results and observed its effect on M. mucogenicum infection. Her symptoms and radiological findings improved significantly. Conclusion: We report a case of NTM-PD caused by a newly identified mycobacteria, Mycolicibacterium toneyamachuris, genetically close to M. mucogenicum. This pathogenic mycobacterium showed different characteristics from M. mucogenicum about clinical presentation and drug sensitivity. The clinical application of genomic sequencing will advance the identification and classification of pathogenic NTM species, and enhance our understanding of mycobacterial diseases. Keywords: Non-tuberculous mycobacteria, Mycolicibacterium toneyamachuris, Mycolicibacterium mucogenicum, Rapid growing mycobacteria
* Correspondence: [email protected] 1 Department of Respiratory Medicine, National Hospital Organization Osaka Toneyama Medical Center, 5-1-1 Toneyama Toyonaka, Osaka, Japan 2 Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated ot
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