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The complexities of elexacaftor/tezacaftor/ivacaftor therapeutic drug monitoring in a person with cystic fibrosis and pulmonary disease.
Eur Clin Respir J
January 2025
Adult Cystic Fibrosis Centre, The Prince Charles Hospital, Brisbane, Queensland, Australia.
Therapeutic drug monitoring (TDM) of elexacaftor/tezacaftor/ivacaftor (ETI) remains challenging due to a lack of clarity around the parameters that govern ETI plasma concentrations, whilst the use of concomitant CYP3A inducers rifabutin and rifampicin is not recommended. We present the complexities of TDM for ETI performed in a person with cystic fibrosis and refractory pulmonary disease. Utilising National Association of Testing Authorities (NATA) accredited assays and target considerations published by the Therapeutic Goods Administration (TGA), Australia, ETI plasma concentration variability was monitored over the course of an acute admission with added complexity from an antibiotic regimen including rifabutin, a moderate cytochrome P450 3A (CYP3A) inducer, and clofazimine, a mild CYP3A inhibitor.
View Article and Find Full Text PDFMultidisciplinary Approaches and Molecular Diagnostics in New-Onset Refractory Status Epilepticus and Nontuberculous Mycobacterial CNS Infections in the ICU: A Case Report.
Cureus
December 2024
Medical Emergency Unit, Unidade Local de Saúde de São José, Lisbon, PRT.
The diagnosis and management of complex neurological conditions such as New-Onset Refractory Status Epilepticus (NORSE) and central nervous system (CNS) infections caused by non-tuberculous mycobacteria (NTM) pose substantial difficulties in intensive care units (ICUs). This article combines a case report and a literature review that explores the diagnostic dilemmas and therapeutic strategies for these critical conditions. We report the case of an 83-year-old female with chronic granulomatous meningitis secondary to NTM, presenting a challenging diagnostic and complex management complexity typical of such a rare disease through a period time of five years.
View Article and Find Full Text PDFIntestinal obstruction caused by disseminated mycobacterium avium complex disease following solid organ transplantation: a case report.
BMC Infect Dis
January 2025
Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan.
Background: Mycobacterium avium complex (MAC) is a common pathogen causing non-tuberculous mycobacterial infections, primarily affecting the lungs. Disseminated MAC disease occurs mainly in immunocompromised individuals, such as those with acquired immunodeficiency syndrome, hematological malignancies, or those positive for anti-interferon-γ antibodies. However, its occurrence in solid organ transplant recipients is uncommon.
View Article and Find Full Text PDFNon-Tuberculous Mycobacterial Infection in AIDS Patients: A Detailed Description of 4 Cases, Including Histopathological Finding.
Rev Med Chil
September 2024
Laboratorio Biología Molecular, Hospital Base de Valdivia, Valdivia, Chile.
Unlabelled: Non tuberculous mycobacteria (NTM) are important opportunistic infection in patients with AIDS.
Aim: To present 4 cases of disseminated infections by NTM in patients with AIDS.
Results: These cases were associated with prolonged symptoms of fever, weight loss, diarrhea or cough, with hepatosplenomegaly, anemia and thrombocytopenia.
A Silent Threat Unveiled: Mycobacterium gordonae Catheter-Related Peritonitis in a Patient on Peritoneal Dialysis.
Cureus
December 2024
Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, THA.
Infectious complications in peritoneal dialysis (PD) remain a constant challenge, with atypical pathogens posing significant risks. This case from Thailand highlights the rare occurrence of , an often-overlooked non-tuberculous mycobacterium (NTM), as the causative agent in a catheter-related exit-site infection that progressed to peritonitis. Initially misattributed to from preceding exit-site infections, was ultimately identified as the primary pathogen through multiple effluent cultures and advance polymerase chain reaction sequencing.
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