Details

Autor(en) / Beteiligte

• Liu, Raymond
• To, Kelvin K. W.
• Teng, Jade L. L.
• Choi, Garnet K. Y.
• Mok, Ka-Yi
• Law, Kin-Ip
• Tso, Eugene Y. K.
• Fung, Kitty S. C.
• Wu, Tak-Chiu
• Wu, Alan K. L.
• Fung, Shing-Hoi
• Wong, Sally C. Y.
• Trendell-Smith, Nigel J.
• Yuen, Kwok-Yung

Titel

Mycobacterium abscessus Bacteremia After Receipt of Intravenous Infusate of Cytokine-Induced Killer Cell Therapy for Body Beautification and Health Boosting

Ist Teil von

• Clinical infectious diseases, 2013-10, Vol.57 (7), p.981-991

Ort / Verlag

Oxford: Oxford University Press

Erscheinungsjahr

2013

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Background. We report the first series of Mycobacterium abscessus bacteremia after cytokine-induced killer cell therapy for body beautification and health boosting. Methods. The clinical manifestations, laboratory and radiological investigations, cytokine/chemokine profiles, and outcomes were described and analyzed. Results. Four patients were admitted, and 3 patients had septic shock. Chest radiographs showed pulmonary infiltrates in all patients. Three patients developed peripheral gangrene, and 1 patient required lower limb and finger amputations. Patient 1 also developed disseminated infection including meningitis and urinary tract infection. Postmortem examination of patient 1 showed focal areas of pulmonary hemorrhage and diffuse alveolar damage, splenic infarct, adrenal necrosis, and hemorrhage, and acid-fast bacilli (AFB) were seen in the lung, liver, kidney, and adrenal gland. Patient 2 developed inguinal granulomatous lymphadenitis about 40 days after onset of lower limb gangrene. Wedge-shaped pulmonary infarcts were found in patient 3, and retinitis and subcutaneous lesions developed in patient 4. Patients in septic shock had dysregulated cytokine/chemokine profiles. Patient 4 with relatively milder presentation had increasing levels of interleukin 17 and cytokines in the interferon-γ/interleukin 12 pathway. All survivors required prolonged intravenous antibiotics. Blood cultures grew M. abscessus for all patients, and admission peripheral blood smear revealed AFB for 3 patients. Mycobacterium abscessus was also isolated from respiratory specimens (2 patients), urine (1 patient), and cerebrospinal fluid (1 patient). Time to initial blood culture positivity (patients 1, 2, and 3: ≤52 hours; patient 4: 83 hours) appeared to correlate with disease severity. Conclusions. Empirical coverage for rapidly growing mycobacteria should be considered in patients with sepsis following cosmetic procedures.