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Case Reports
. 2020 Nov 25;20(1):888.
doi: 10.1186/s12879-020-05626-y.

Pulmonary disease caused by a newly identified mycobacterium: Mycolicibacterium toneyamachuris: a case report

Tomoki Kuge  1 , Kiyoharu Fukushima  2   3   4 , Yuki Matsumoto  5 , Yuko Abe  6 , Eri Akiba  1 , Kako Haduki  1 , Haruko Saito  1 , Tadayoshi Nitta  1 , Akira Kawano  1 , Takahiro Kawasaki  1 , Takanori Matsuki  1 , Hiroyuki Kagawa  1 , Daisuke Motooka  5 , Kazuyuki Tsujino  1 , Mari Miki  1 , Keisuke Miki  1 , Seigo Kitada  7 , Shota Nakamura  5 , Tetsuya Iida  5 , Hiroshi Kida  1
Affiliations
Case Reports

Pulmonary disease caused by a newly identified mycobacterium: Mycolicibacterium toneyamachuris: a case report

Tomoki Kuge et al. BMC Infect Dis. .

Abstract

Background: Non-tuberculous mycobacterial pulmonary disease (NTM-PD) is becoming a significant health burden. Recent advances in analysis techniques have allowed the accurate identification of previously unknown NTM species. Here, we report a case of NTM-PD caused by a newly identified mycobacteria in an immunocompetent patient.

Case presentation: A 44-year-old woman was referred to our hospital due to the frequent aggravation of her chronic respiratory symptoms, with NTM-PD-compatible computed tomography findings. Unidentified mycobacterium was repeatedly isolated from respiratory specimens and we diagnosed her as NTM-PD of unidentified mycobacterium. Subsequent whole-genome analysis revealed that the unidentified mycobacterium was a novel mycobacterium genetically close to Mycolicibacterium mucogenicum. We started combination therapy with clarithromycin, moxifloxacin, amikacin, and imipenem/cilastatin, referring to drug sensitivity test results and observed its effect on M. mucogenicum infection. Her symptoms and radiological findings improved significantly.

Conclusion: We report a case of NTM-PD caused by a newly identified mycobacteria, Mycolicibacterium toneyamachuris, genetically close to M. mucogenicum. This pathogenic mycobacterium showed different characteristics from M. mucogenicum about clinical presentation and drug sensitivity. The clinical application of genomic sequencing will advance the identification and classification of pathogenic NTM species, and enhance our understanding of mycobacterial diseases.

Keywords: Mycolicibacterium mucogenicum; Mycolicibacterium toneyamachuris; Non-tuberculous mycobacteria; Rapid growing mycobacteria.

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Conflict of interest statement

The authors declare no conflicts of interest to declare. Readers are welcome to comment on the online version of the paper. Correspondence and requests for materials should be addressed to KF. (fukushima@imed3.med.osaka-u.ac.jp).

Figures

Fig. 1
Fig. 1
Chest CT before treatment shows small centrilobular nodules in the middle and lower lobes and slight bronchiectasis with a consolidation in the middle lobe (a). After 2 months treatment, small centrilobular nodules almost vanished (b)
Fig. 2
Fig. 2
Approximately maximum likelihood phylogenetic tree using 16S rRNA sequences. Sequences were obtained from SILVA database release 138 as SSU Ref NR 99 sequences, which were showing larger than 98.7% of identity to the strain XXX T or derived from the type strains of Mycobacterium kansasii and Mycobacteroides abscessus
See this image and copyright information in PMC

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