Open Access Case report

Probable disseminated Mycobacterium abscessus subspecies bolletii infection in a patient with idiopathic CD4+ T lymphocytopenia: a case report

Claudia Colomba1,2, Raffaella Rubino1,2*, Paola Di Carlo1,2, Caterina Mammina1,2, Celestino Bonura1, Lucia Siracusa1,2, Lucina Titone1,2 and Laura Saporito1,2

Author Affiliations

1 Dipartimento di Scienze per la Promozione della Salute, Università di Palermo, Via del Vespro 129, Palermo, 90127, Italy

2 Dipartimento di Scienze per la Promozione della Salute, Sezione di Malattie Infettive, Università di Palermo, Via del Vespro 129, Palermo, 90127, Italy

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Journal of Medical Case Reports 2012, 6:277 doi:10.1186/1752-1947-6-277

Published: 4 September 2012

Abstract

Introduction

Rapidly growing mycobacteria are opportunistic pathogens in patients with underlying risk factors. Mycobacterium abscessus subsp. bolletii is a newly recognized member of rapidly growing mycobacteria, isolated from respiratory tract and cutaneous infections.

Case presentation

We describe a case of chronic disseminated infection caused by M. abscessus subsp. bolletii in a 38-year-old Sri Lankan man with idiopathic CD4+ T lymphocytopenia. Idiopathic CD4+ T lymphocytopenia is a rare cause of immunodysfunction that, similar to human immunodeficiency virus infection, causes a depletion of CD4+ T lymphocytes. M. abscessus subsp. bolletii infection was diagnosed by culture isolation from two sputum samples.

Conclusions

To the best of our knowledge this is the first report of M. abscessus subsp. bolletii disseminated infection in a patient affected by idiopathic CD4+ T lymphocytopenia. In contrast to previous reports, the isolate of M. abscessus subsp. bolletii presented intermediate resistance to clarithromycin and was susceptible to cefoxitin and imipenem.

Keywords:
CD4+ T lymphocytopenia; Clarithromycin; Disseminated infection; Mycobacterium abscessus subsp. bolletii rapidly growing mycobacteria