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Journal of Clinical Microbiology, March 2006, p. 837-840, Vol. 44, No. 3
0095-1137/06/$08.00+0     doi:10.1128/JCM.44.3.837-840.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Report of Two Fatal Cases of Mycobacterium mucogenicum Central Nervous System Infection in Immunocompetent Patients

Toïdi Adékambi, Cedric Foucault, Bernard La Scola, and Michel Drancourt*

Unité des Rickettsies, CNRS UMR 6020 IFR 48, Faculté de Médecine, Université de la Méditerranée, and Assistance Publique-Hôpitaux de Marseille Timone Fédération de Microbiologie Clinique, Marseille, France

Received 2 June 2005/ Returned for modification 28 October 2005/ Accepted 23 December 2005

Neurological infections due to rapidly growing mycobacteria (RGM) have rarely been reported. We recently investigated two unrelated immunocompetent patients, one with community-acquired lymphocytic meningitis and the other with cerebral thrombophlebitis. Mycobacterium mucogenicum was isolated in pure culture and detected by PCR sequencing of cerebrospinal fluid samples. Both patients eventually died. The two isolates exhibited an overlapping antimicrobial susceptibility pattern. They were susceptible in vitro to tetracyclines, macrolides, quinolones, amikacin, imipenem, cefoxitin, and trimethoprim-sulfamethoxazole and resistant to ceftriaxone. They shared 100% 16S rRNA gene sequence similarity with M. mucogenicum ATCC 49650T over 1,482 bp. Their partial rpoB sequences shared 97.8% and 98.1% similarity with M. mucogenicum ATCC 49650T, suggesting that the two isolates were representative of two sequevars of M. mucogenicum species. This case report should make clinicians aware that M. mucogenicum, an RGM frequently isolated from tap water or from respiratory specimens and mostly without clinical significance, can even be encountered in the central nervous system of immunocompetent patients.

* Corresponding author. Mailing address: Unité des Rickettsies, Faculté de Médecine, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 05, France. Phone: (33) 04 91 32 43 75. Fax: (33) 04 91 38 77 72. E-mail: Michel.Drancourt{at}medecine.univ-mrs.fr.

Journal of Clinical Microbiology, March 2006, p. 837-840, Vol. 44, No. 3
0095-1137/06/$08.00+0     doi:10.1128/JCM.44.3.837-840.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



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