Isolated vitritis as the presenting feature of disseminated Mycobacterium chelonae subspecies gwanakae, a novel subspecies.

Q3 Medicine Retinal Cases and Brief Reports Pub Date : 2025-02-12 DOI:10.1097/ICB.0000000000001733

Samantha S Massenzio, Ajay E Kuriyan, Tatyana Milman, Nicole D Pecora, Matthew A Pettengill, John J Zurlo, Jordan D Deaner

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Abstract

Purpose: To report a case of isolated vitritis as the presenting feature of a disseminated infection with Mycobacterium chelonae subspecies gwanakae, a novel subspecies.

Methods: Case report.

Results: A 66-year-old male who presented with progressive floaters and blurred vision was found to have isolated vitritis of the left eye. Diagnostic vitrectomy revealed acid-fast bacilli in the vitreous. Whole genome sequencing identified the organism as Mycobacterium chelonae subspecies gwanakae, a recently identified novel subspecies. The patient was admitted for further evaluation and treatment. Punch biopsies of the numerous ulcerative skin lesions revealed acid-fast bacilli. Magnetic resonance imaging revealed osteomyelitis underlying the soft tissue infections, requiring incision and drainage. Biopsy of the bone also revealed acid-fast bacilli. He was treated with weekly intravitreal amikacin and empiric intravenous azithromycin, imipenem, and tobramycin. His ocular infection responded well to treatment with resolution of the vitritis and improvement in visual acuity. Unfortunately, his systemic condition deteriorated, and he declined further intervention, ultimately succumbing to his systemic infection 12 weeks after presentation.

Conclusion: Isolated vitritis can be the presenting feature of a severe disseminated Mycobacterium chelonae subspecies gwanakae infection.

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目的：报告一例以孤立性玻璃体炎为主要特征的新型瓜纳凯分枝杆菌亚种播散性感染病例：方法：病例报告：结果：一名66岁的男性患者出现进行性浮游物和视力模糊，被发现患有左眼孤立性玻璃体炎。诊断性玻璃体切除术在玻璃体内发现了耐酸杆菌。通过全基因组测序，确定该病菌为克氏分枝杆菌gwanakae亚种，这是最近发现的一个新亚种。患者入院接受进一步评估和治疗。对多处溃疡性皮损进行的冲孔活检发现了耐酸杆菌。磁共振成像显示，软组织感染的基础是骨髓炎，需要切开引流。骨骼活检也发现了耐酸杆菌。他接受了每周静脉注射阿米卡星和静脉注射阿奇霉素、亚胺培南和妥布霉素的治疗。他的眼部感染对治疗反应良好，玻璃体炎症得到缓解，视力也有所提高。不幸的是，他的全身状况恶化，他拒绝接受进一步治疗，最终在发病 12 周后死于全身感染：结论：孤立性玻璃体炎可能是严重播散性广瓦纳卡氏分枝杆菌感染的表现特征。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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