Mycobacterium mucogenicum Central Venous Line Infection: Successful Treatment in a 2-Year-Old Child without Line Removal

Abstract

We report the first case of successful treatment of Mycobacterium mucogenicum central venous line (CVL) infection which did not require removal and replacement of the line. A 2-year-old boy with type 3 intestinal failure on long-term home parenteral nutrition via CVL, presented to the emergency department with fever and tachycardia. CVL infection was suspected and amikacin and piperacillin/tazobactam were started immediately in line with local protocol. Consecutive blood cultures grew M. mucogenicum, a rapidly growing nontuberculous mycobacterium species. Following consultation with microbiology, the agreed course of action was to treat the infection with antibiotics while leaving the CVL in place. Clarithromycin and ciprofloxacin were added, and subsequent blood culture on day 6 of treatment showed no bacterial growth. He completed 14 days of antibiotics and has remained well with no further line infection to date (6 months postpresentation). Knowledge that this infection may be successfully treated with the appropriate antibiotics could give clinicians confidence to leave a CVL in place if the patient is clinically stable and immunocompetent. This is of significant importance when preserving vascular access is crucial.