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Original ArticleOpen Access
Rapidly Growing Mycobacterial Infections : Spectrum of Diseases, Antimicrobial Susceptibility, Pathology and Treatment Outcomes
Sungkanuparph S 
,
Sathapatayavongs B ,
Pracharktam R
,
Sathapatayavongs B ,
Pracharktam R SOMNUEK SUNGKANUPARPH, MD*,
BOONMEE SATHAPATA Y A VONGS, MD*,
ROONGNAPA PRACHARKTAM, MSc**
Objectives : A series of cases infected with rapidly growing mycobacteria were studied to
reveal the spectrum of disease, antimicrobial susceptibility, pathology, and treatment outcomes.
Method : The cases identified as rapidly growing mycobacterial infections in Ramathibodi
Hospital from January 1993 to June 1999 were retrospectively studied.
Results :There were 20 patients and most of the cases had no underlying disease. Only two
cases were HIV -infected patients. The presenting clinical features were lymphadenitis (7), skin and
subcutaneous abscess (7), eye infection (4), pulmonary infection (1), and chronic otitis media (1). Four
of the seven cases with lymphadenitis had Sweet's syndrome. The organisms were
Mycobacterium
chelonae/abscessus
group (17 cases) and
Mycobacterium fortuitum
group (3 cases). The organisms
were susceptible to amikacin, netilmicin and imipenem. TheM.
fortuitum
group was susceptible to more
antibiotics than the
M. chelonae/abscessus
group. Pathology of the infected tissue varied from non-
specific findings to suppurative or caseous granuloma. The clinical responses corresponded to the anti-
microbial susceptibility. Most of the patients had a good clinical outcome. A combination of two or
more drugs was used for the medical treatment. Surgical resection was performed where possible to
reduce the load of the organism, especially in cases with very resistant organisms.
Conclusions : Rapidly growing mycobacterial infections can occur in apparently normal
hosts. Clinical syndrome is variable. The pathology is non-specific and culture is needed for definite
diagnosis. Clinical responses varied but seemed to correlate with the
in vitro
susceptibility result. More
studies are needed before one can deal with these infections more effectively.
Key word :
Mycobacterium fortuitum, Mycobacterium chelonae, Mycobacterium abscessus,
Rapidly
Growing Mycobacteria, Susceptibility, Pathology, Lymphadenitis, Sweet's Syndrome, Out-
come
BOONMEE SATHAPATA Y A VONGS, MD*,
ROONGNAPA PRACHARKTAM, MSc**
Objectives : A series of cases infected with rapidly growing mycobacteria were studied to
reveal the spectrum of disease, antimicrobial susceptibility, pathology, and treatment outcomes.
Method : The cases identified as rapidly growing mycobacterial infections in Ramathibodi
Hospital from January 1993 to June 1999 were retrospectively studied.
Results :There were 20 patients and most of the cases had no underlying disease. Only two
cases were HIV -infected patients. The presenting clinical features were lymphadenitis (7), skin and
subcutaneous abscess (7), eye infection (4), pulmonary infection (1), and chronic otitis media (1). Four
of the seven cases with lymphadenitis had Sweet's syndrome. The organisms were
Mycobacterium
chelonae/abscessus
group (17 cases) and
Mycobacterium fortuitum
group (3 cases). The organisms
were susceptible to amikacin, netilmicin and imipenem. TheM.
fortuitum
group was susceptible to more
antibiotics than the
M. chelonae/abscessus
group. Pathology of the infected tissue varied from non-
specific findings to suppurative or caseous granuloma. The clinical responses corresponded to the anti-
microbial susceptibility. Most of the patients had a good clinical outcome. A combination of two or
more drugs was used for the medical treatment. Surgical resection was performed where possible to
reduce the load of the organism, especially in cases with very resistant organisms.
Conclusions : Rapidly growing mycobacterial infections can occur in apparently normal
hosts. Clinical syndrome is variable. The pathology is non-specific and culture is needed for definite
diagnosis. Clinical responses varied but seemed to correlate with the
in vitro
susceptibility result. More
studies are needed before one can deal with these infections more effectively.
Key word :
Mycobacterium fortuitum, Mycobacterium chelonae, Mycobacterium abscessus,
Rapidly
Growing Mycobacteria, Susceptibility, Pathology, Lymphadenitis, Sweet's Syndrome, Out-
come
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