IntroductionMycobacterium abscessus is a rapidly growing nontuberculous mycobacterium that most commonly causes pulmonary, skin and soft tissue, or postoperative wound infections. Bloodstream infection due to M.
abscessus is uncommon and is usually reported in patients with immune dysfunction, major comorbidity, or healthcare-associated exposure.Case presentationWe describe a 66-year-old man who presented with recurrent fever, myalgia, fatigue, dizziness, cough, and urinary urgency. His medical history was notable for poorly controlled type 2 diabetes mellitus, hypertension, prior cerebral infarction, coronary artery bypass grafting, lumbar spine surgery, and a recent episode of septic shock caused by Mycobacterium abscessus.
During hospitalization, he developed recurrent high-grade fever and hemodynamic instability consistent with septic shock. Blood cultures yielded M.
abscessus, while sputum smear microscopy demonstrated acid-fast bacilli; GeneXpert testing was negative for Mycobacterium tuberculosis. Species identification was established by MALDI-TOF mass spectrometry and further verified by melting-curve analysis.
Additional evaluation showed persistent systemic inflammation, thrombocytopenia, cardiac dysfunction, and impaired cellular immunity. He received combination antimicrobial therapy together with supportive treatment, but remained intermittently febrile and symptomatic.
This report describes a bloodstream infection due to Mycobacterium abscessus in a medically complex adult.
The organism is noted as a rapidly growing nontuberculous mycobacterium that more commonly causes pulmonary, skin/soft tissue, or wound infections; bacteremia is characterized as uncommon and typically associated with immune dysfunction, major comorbidity, or healthcare exposures.