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- Title
Mycobacterium abscessus Bacteremia After Receipt of Intravenous Infusate of Cytokine-Induced Killer Cell Therapy for Body Beautification and Health Boosting.
- Authors
Liu, Raymond; To, Kelvin K. W.; Teng, Jade L. L.; Choi, Garnet K. Y.; Mok, Ka-Yi; Law, Kin-Ip; Tso, Eugene Y. K.; Fung, Kitty S. C.; Wu, Tak-Chiu; Wu, Alan K. L.; Fung, Shing-Hoi; Wong, Sally C. Y.; Trendell-Smith, Nigel J.; Yuen, Kwok-Yung
- Abstract
Four patients suffered from Mycobacterium abscessus bacteremia after infusion of cytokine-induced killer cell therapy for body beautification and health boosting. Three patients required intensive care and 1 patient died. The clinical, pathological, microbiological, and cytokine profiles were described and analyzed.Background. We report the first series of Mycobacterium abscessus bacteremia after cytokine-induced killer cell therapy for body beautification and health boosting.Methods. The clinical manifestations, laboratory and radiological investigations, cytokine/chemokine profiles, and outcomes were described and analyzed.Results. Four patients were admitted, and 3 patients had septic shock. Chest radiographs showed pulmonary infiltrates in all patients. Three patients developed peripheral gangrene, and 1 patient required lower limb and finger amputations. Patient 1 also developed disseminated infection including meningitis and urinary tract infection. Postmortem examination of patient 1 showed focal areas of pulmonary hemorrhage and diffuse alveolar damage, splenic infarct, adrenal necrosis, and hemorrhage, and acid-fast bacilli (AFB) were seen in the lung, liver, kidney, and adrenal gland. Patient 2 developed inguinal granulomatous lymphadenitis about 40 days after onset of lower limb gangrene. Wedge-shaped pulmonary infarcts were found in patient 3, and retinitis and subcutaneous lesions developed in patient 4. Patients in septic shock had dysregulated cytokine/chemokine profiles. Patient 4 with relatively milder presentation had increasing levels of interleukin 17 and cytokines in the interferon-γ/interleukin 12 pathway. All survivors required prolonged intravenous antibiotics. Blood cultures grew M. abscessus for all patients, and admission peripheral blood smear revealed AFB for 3 patients. Mycobacterium abscessus was also isolated from respiratory specimens (2 patients), urine (1 patient), and cerebrospinal fluid (1 patient). Time to initial blood culture positivity (patients 1, 2, and 3: ≤52 hours; patient 4: 83 hours) appeared to correlate with disease severity.Conclusions. Empirical coverage for rapidly growing mycobacteria should be considered in patients with sepsis following cosmetic procedures.
- Subjects
MYCOBACTERIUM; CYTOKINES; KILLER cells; INTRAVENOUS therapy; CRITICAL care medicine; PATHOLOGY; MICROBIOLOGY
- Publication
Clinical Infectious Diseases, 2013, Vol 57, Issue 7, p981
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/cit443