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Mycobacterium chelonae dacryocystitis after endoscopic dacryocystorhinostomy

Mycobacterium chelonae is a rapidly growing nontuberculous Mycobacterium and an uncommon cause of aggressive, treatment-resistant ocular and periocular infection. This is the first known case report of a woman who developed unilateral M. chelonae dacryocystitis after undergoing endoscopic sinus surg...

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Autores principales: Meyer, Annika, Prasad, Kumar G., Antisdel, Jastin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: OceanSide Publications, Inc. 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4124583/
https://www.ncbi.nlm.nih.gov/pubmed/24613068
http://dx.doi.org/10.2500/ar.2014.5.0081
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author Meyer, Annika
Prasad, Kumar G.
Antisdel, Jastin
author_facet Meyer, Annika
Prasad, Kumar G.
Antisdel, Jastin
author_sort Meyer, Annika
collection PubMed
description Mycobacterium chelonae is a rapidly growing nontuberculous Mycobacterium and an uncommon cause of aggressive, treatment-resistant ocular and periocular infection. This is the first known case report of a woman who developed unilateral M. chelonae dacryocystitis after undergoing endoscopic sinus surgery and right endoscopic dacryocystorhinostomy (DCR) with Crawford stent placement. We describe our findings and effective methods to manage the infection. Three weeks after undergoing DCR, the patient acutely developed symptoms consistent with dacryocystitis. The patient was treated with broad-spectrum antibiotics followed by incision and drainage of the dacryocystocele abscess, with initial cultures showing no organisms. With continued signs of infection, the Crawford stent was later removed. Cultures eventually grew M. chelonae and the patient was treated with 4 months of antibiotic therapy. While receiving antibiotics, the patient developed three abscesses along the inferior lid requiring excision. After 21 months, the patient remains free of infection and has not experienced any other complications. This case serves as a reminder to consider M. chelonae as a potential cause of periocular infection, which may be more likely to occur postoperatively with indwelling devices, as well as in patients with sinonasal issues requiring nasal irrigations. This organism can be difficult to treat because of multidrug resistance and biofilm production. Recommended therapy includes surgical debridement, removal of any implanted devices, and a two-drug antibiotic regimen for at least 4 months.
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spelling pubmed-41245832014-08-07 Mycobacterium chelonae dacryocystitis after endoscopic dacryocystorhinostomy Meyer, Annika Prasad, Kumar G. Antisdel, Jastin Allergy Rhinol (Providence) Articles Mycobacterium chelonae is a rapidly growing nontuberculous Mycobacterium and an uncommon cause of aggressive, treatment-resistant ocular and periocular infection. This is the first known case report of a woman who developed unilateral M. chelonae dacryocystitis after undergoing endoscopic sinus surgery and right endoscopic dacryocystorhinostomy (DCR) with Crawford stent placement. We describe our findings and effective methods to manage the infection. Three weeks after undergoing DCR, the patient acutely developed symptoms consistent with dacryocystitis. The patient was treated with broad-spectrum antibiotics followed by incision and drainage of the dacryocystocele abscess, with initial cultures showing no organisms. With continued signs of infection, the Crawford stent was later removed. Cultures eventually grew M. chelonae and the patient was treated with 4 months of antibiotic therapy. While receiving antibiotics, the patient developed three abscesses along the inferior lid requiring excision. After 21 months, the patient remains free of infection and has not experienced any other complications. This case serves as a reminder to consider M. chelonae as a potential cause of periocular infection, which may be more likely to occur postoperatively with indwelling devices, as well as in patients with sinonasal issues requiring nasal irrigations. This organism can be difficult to treat because of multidrug resistance and biofilm production. Recommended therapy includes surgical debridement, removal of any implanted devices, and a two-drug antibiotic regimen for at least 4 months. OceanSide Publications, Inc. 2014 2014-03-07 /pmc/articles/PMC4124583/ /pubmed/24613068 http://dx.doi.org/10.2500/ar.2014.5.0081 Text en Copyright © 2014, OceanSide Publications, Inc., U.S.A. This publication is provided under the terms of the Creative Commons Public License ("CCPL" or "License"), in attribution 3.0 unported (Attribution Non-Commercial No Derivatives (CC BY-NC-ND)), further described at: http://creativecommons.org/licenses/by-nc-nd/3.0/legalcode. The work is protected by copyright and/or other applicable law. Any use of the work other then as authorized under this license or copyright law is prohibited.
spellingShingle Articles
Meyer, Annika
Prasad, Kumar G.
Antisdel, Jastin
Mycobacterium chelonae dacryocystitis after endoscopic dacryocystorhinostomy
title Mycobacterium chelonae dacryocystitis after endoscopic dacryocystorhinostomy
title_full Mycobacterium chelonae dacryocystitis after endoscopic dacryocystorhinostomy
title_fullStr Mycobacterium chelonae dacryocystitis after endoscopic dacryocystorhinostomy
title_full_unstemmed Mycobacterium chelonae dacryocystitis after endoscopic dacryocystorhinostomy
title_short Mycobacterium chelonae dacryocystitis after endoscopic dacryocystorhinostomy
title_sort mycobacterium chelonae dacryocystitis after endoscopic dacryocystorhinostomy
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4124583/
https://www.ncbi.nlm.nih.gov/pubmed/24613068
http://dx.doi.org/10.2500/ar.2014.5.0081
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