Bloodstream Infection Associated with a Totally Implanted Subclavian Port in an Adult with Diabetes and History of Colon Cancer.

Case Rep Infect Dis

Section of Infectious Diseases, Medical Service, Oklahoma City VA Medical Center, Department of Medicine, Oklahoma University Health Sciences Center, 921 NE 13th Street, Oklahoma City 73104, OK, USA.

Published: December 2020

. is a rapidly growing nontuberculosis mycobacterium (NTM) that was first isolated from soil in 1972 and is ubiquitous in soil, water, and dust. The first reported case of human infection by was published in 1988, presenting as a Hickman catheter-related bacteremia in a patient with ovarian cancer. has since been recognized as a source of predominantly opportunistic bloodstream infections in immunocompromised hosts. We report the case of an adult diabetic male with bloodstream infection secondary to an infected venous-access port that had been implanted nearly six years prior for temporary chemotherapy. . A 66-year-old male with schizophrenia, type 2 diabetes mellitus, and a history of excision and chemotherapy to treat adenocarcinoma of the colon 6 years prior, presented with fever and behavioral changes. He was found to have a bloodstream infection secondary to his implanted subclavian port. Multiple preoperative blood cultures, as well as the removed catheter tip culture, were positive for . The patient's condition improved to near premorbid levels after port removal and 6 weeks of targeted antimicrobial therapy. . Bloodstream infections due to rapidly growing NTM, such as , have been infrequently reported; however, improved isolation and identification techniques based on genomic testing are resulting in a more in-depth recognition of these widely scattered environmental microbes in human infections. Nonetheless, lengthy identification and susceptibility processes remain a diagnostic and treatment barrier. Patients such as ours who have a history of malignancy and an indwelling foreign body have most often been reported as acquiring bacteremia. Fortunately, device removal and appropriate antimicrobial therapy guided by susceptibility data is often enough to manage these atypical mycobacterial infections.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7790582PMC
http://dx.doi.org/10.1155/2020/8878069DOI Listing

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