Mycobacterium Aurum/Neoaurum Bacteremia: A Case Report and Review of the Literature

1Mayo Clinic Jacksonville, Jacksonville, FL

Meeting: Hospital Medicine 2007, May 23-25, Dallas, Texas

Abstract number: 109

Case Presentation:

A 49‐year‐old woman was admitted to the hospital with fevers, chills, and hematuria and found to have urosepsis with Enterococcus faecalis. Her medical history included ischeal tuberosity ulcer from pressure necrosis and resulting pelvic osteomyelitis with group C streptococcus. A peripherally inserted central catheter (PICC) line had been placed 3 months prior to this admission for long‐term intravenous antibiotic management of osteomyelitis. The PICC line had not been removed after completion of antimicrobial therapy. On presentation, exam of this patient showed she was negative for lymphadenopathy or erythema at the PICC site. Initial laboratory results revealed a normal white blood cell count of 10 with normal differential.

On the second day of admission, repeat blood cultures drawn through the PICC grew M. aurum/neoaurum in addition to the Enterococ‐cus faecalis. Blood cultures remained persistently positive for M. aurum/neoaurum for 7 days, despite clearance of the E. faecalis. After PICC line removal, all cultures were negative. Bone and abscess cultures were negative for acid‐fast bacilli.

Therapy was based on antimicrobial sensitivity, with imipenem for6 weeks and clarithromycin, ciprofloxacin, and doxycycline orallyfor3 months. At the time of follow‐up she had gained weight and was doing well.

Discussion:

Mycobacterium aurum and Mycobacterium neoaurum have been described relatively recently, the former in 1966 and the latter in 1972. They are members of the Mycobacterium parafortuitum complex. M. neoaurum is a rapidly growing scotochromogen, first described after being isolated from soil in Japan. Although M. aurum and M. neoaurum have been well documented in soil, dust, and water, they are very rarely encountered in human disease.

Ten cases of human infection from M. aurum/neoaurum have been described in the literature (see tables). In most reported cases, these infections occurred in patients with long‐term indwelling catheters in immunocompromised hosts.

Conclusions:

This rapidly growing mycobacterium, previously believed to be nonpathogenic, should be considered a potential pathogen when isolated in the setting of indwelling catheters, such as PICC lines or Hickman catheters. M. aurum/neoaurum should not be dismissed as a contaminant, and emphasis on removal of catheters promptly after completion of therapy is essential to prevention of infection.

Author Disclosure:

S. Alvarez, None; L. Brumble, None; M. S. Hedges, None.

To cite this abstract:

Alvarez S, Brumble L, Hedges M. Mycobacterium Aurum/Neoaurum Bacteremia: A Case Report and Review of the Literature. Abstract published at Hospital Medicine 2007, May 23-25, Dallas, Texas Abstract 109. Journal of Hospital Medicine. 2007; 2 (suppl 2). https://www.shmabstracts.com/abstract/mycobacterium-aurumneoaurum-bacteremia-a-case-report-and-review-of-the-literature/. Accessed May 26, 2019.

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