Mycobacterium septicum

Mycobacterium septicum is a rarely identified nontuberculous mycobacterium (NTM) that can cause infections in both healthy and immunocompromised individuals.

Few cases of M. septicum infection have been published (<10) , making recognition of corresponding clinical disease difficult for clinicians.

Most cases have been identified from sputum specimens of individuals with underlying pulmonary disease. Catheter-associated bkateremia has also been reported (Schinsky MF et al. 2000). Many cases in which M. septicum has been isolated in cultures are considered clinically irrelevant. Isolation of M. septicum in culture necessarily requires clinical correlation to determine clinical relevance and thus the need for treatment (Go JR et al. 2020).

Skin infections caused by M. septicum have previously been reported following cosmetic surgery (Shin H et al. 2020).

Most M. septicum isolates are sensitive in vitro to amikacin, ciprofloxacin, imipenem, linezolid, moxifloxacin, and trimethoprim-sulfamethoxazole.

Resistance was found to clarithromycin and doxycycline.

Case Report:

A 37-year-old woman had persistent bilateral swelling of the upper eyelids 3 months after blepharoplasty. Excision and revision were performed and clarithromycin was administered for 2 months. Under this, renewed inflammatory swelling of the eyelids. A new revision revealed microbiological evidence of M. septicum. Under a 6-month treatment with levofloxacin and clarithromycin, the infection healed.

1. Go JR et al (2020) Mycobacterium septicum: a 6-Year Clinical Experience from a Tertiary Hospital and Reference Laboratory. J Clin Microbiol 58:e02091-20.
2. Shin H et al. (2020) Surgical Site Infection Caused by Mycobacterium Septicum Following Blepharoplasty. J Craniofac Surg 31:e228-e230.
3. Schinsky MF et al (2000) Mycobacterium septicum sp. nov. a new rapidly growing species associated with catheter-related bacteraemia. Int J Syst Evol Microbiol 50 Pt 2:575-581.