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Volume 23, Number 10—October 2017
Research Letter

Mycobacterium riyadhense in Saudi Arabia

Bright Varghese, Mushirah Abdulaziz Enani, Sahar Althawadi, Sameera Johani, Grace Mary Fernandez, Hawra Al-Ghafli, and Sahal Al-HajojComments to Author 
Author affiliations: King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia (B. Varghese, S. Althawadi, G.M. Fernandez, H. Al-Ghafli, S. Al-Hajoj); King Fahad Medical City, Riyadh (M.A. Enani); King Abdul Aziz Medical City, Riyadh (S. Johani)

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Table

Summary of all reported Mycobacterium riyadhense infections in Saudi Arabia and other countries*

Case Age, y/sex Nationality City Region/ country Specimen Smear/ culture results Clinical relevance† Treatment† Treatment outcome
This study
1 25/M Saudi Dammam Eastern/ Saudi Arabia Sputum ++/+ Yes CLR/INH/RFP Cured
2 55/M Saudi Riyadh Central/ Saudi Arabia BAL –/+ Yes INH/RFP/EMB/PZA Cured
3 39/F Non-Saudi Riyadh Central/ Saudi Arabia Sputum +/+ Yes INH/RFP/EMB/PZA Cured
4 77/M Saudi Riyadh Central/ Saudi Arabia Tracheal aspirate +/+ Yes INH/RFP Cured
5 57/M Saudi Riyadh Central/ Saudi Arabia Lymph node –/+ Yes INH/RFP/CLR Cured
6 82/M Saudi Riyadh Central/ Saudi Arabia BAL –/+ Yes CLR/INH/RFP Cured
7 18/M Saudi Riyadh Central/ Saudi Arabia Gastric aspirate +/+ Yes INH/RFP/EMB/PZA Cured
8 32/M Non-Saudi Riyadh Central/ Saudi Arabia Endotracheal aspirate –/+ Yes CLR/INH/RFP Cured
9 61/M Saudi Riyadh Central/ Saudi Arabia Sputum +/+ Yes INH/RFP NA
10 8/M Saudi Riyadh Central/ Saudi Arabia Lymph node –/+ Yes CLR/INH/RFP Cured
11 82/M Saudi Dammam Eastern/ Saudi Arabia Sputum +/+ No INH/RFP Died
12
 28/M
 Saudi
 Riyadh
 Central/ Saudi Arabia
 Lymph node
 –/+
 Yes
 INH/RFP
 Cured
Previous reports
(1) 19/M Saudi Riyadh Central/ Saudi Arabia Bone infection in maxillary sinus –/+ Yes INH/RIF/EMB/PZA Cured
(2) 38/F South Korea NA South Korea Sputum +/+ Yes INH/RIF/EMB/PZA Cured
(3) 39/F France Toulon France Sputum +/+ Yes INH/RIF/EMB/PZA Cured
(4) 43/M Bahrain Awali Bahrain Sputum –/+ Yes INH/RIF/EMB/PZA/CLR/CIP Cured
(5) 18/F Saudi Jeddah West/
Saudi Arabia Brain with bone –/+ Yes INH/RIF/EMB/PZA/MX Cured
(6) 24/F Saudi Riyadh Central/
Saudi Arabia Spine –/+ Yes INH/RIF/EMB/PZA Cured
(7) 30/M Saudi NA West/
Saudi Arabia Sputum + lymph node +/+ Yes INH/RIF/EMB/PZA Cured
(8) 54/M Saudi NA Central/
Saudi Arabia BAL +/+ Yes INH/RIF/EMB/PZA Cured

*BA, bronchoalveolar lavage; NA, not available; +, positive; -, negative. Positive smearing results indicate the presence of acid-fast bacilli (AFB). Wherein, 10–99 AFB identified in 100 fields have been noted with (+), and 100–999 AFB in 100 fields correlates with (++). Positive culturing results highlight the presence of mycobacterial growth. CIP, ciprofloxacin; CLR, clarithromycin; EMB, ethambutol; INH, isoniazid; MX, moxifloxacin; PZA, pyrazinamide; RFP, rifampin.
†Based on American Thoracic Society guidelines for pulmonary NTM disease/colonization (https://www.thoracic.org/statements/resources/mtpi/nontuberculous-mycobacterial-diseases.pdf).

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