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Mycobacterium abscessus Associated Peritonitis with CAPD Successfully Treated Using a Linezolid and Tedizolid Containing Regimen Suggested Immunomodulatory Effects

Challenging differential diagnosis, Unusual or unexpected effect of treatment, Patient complains / malpractice, Rare disease

Masafumi Seki, Yasuhiro Kamioka, Kazuki Takano, Haruka Imai, Mai Shoji, Maya Hariu, Yukari Kabutoya, Yuji Watanabe

Japan Division of Infectious Diseases and Infection Control, Tohoku Medical and Pharmaceutical University Hospital, Sendai, Miyagi, Japan

Am J Case Rep 2020; 21:e924642

DOI: 10.12659/AJCR.924642

Available online: 2020-05-19

Published: 2020-06-29


#924642

BACKGROUND: Mycobacterium abscessus is one of the most important mycobacteria, but its associated peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD) appears relative rare, and the treatment regimen of the antibiotics are still unclear.
CASE REPORT: A 38-year-old female with chronic glomerulonephritis on CAPD who was diagnosed with M. abscessus-associated peritonitis. Symptoms exacerbated despite treatment with a 3-antibiotic regimen combining clarithromycin, imipenem/cilastatin (IPM/CS), and minocycline (MINO). However, after changing IPM/CS and MINO to linezolid (LZD), her condition and inflammation improved, and she was able to be maintained on oral tedizolid (TZD).
CONCLUSIONS: Oxazolidinones such as LZD and TZD might be candidate antibiotics for the treatment of M. abscessus-associated diseases with chronic renal failure due to their immunomodulatory effects and non-renal excretion.

Keywords: Antibiotics, Antitubercular, Immunocompromised Host, Mycobacterium Infections, Nontuberculous, Renal Insufficiency, Chronic



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