Volume 28, Number 7—July 2022
Dispatch
Chronic Pulmonary Disease Caused by Tsukamurella toyonakaense
Table 2
Characteristics of 10 patients who had Tukamurella pulmonary disease*
Report author, year | Patient, age, y/sex/country | Medical history | Signs/symptoms | Imaging findings | Initial diagnosis of infection | Identified pathogen/ diagnostic method | Initial treatment; clinical response | Subsequent treatment |
---|---|---|---|---|---|---|---|---|
Tsukamura et al., 1982 | 50/M/Japan | None | Fever, cough for 1 week | Cavity, pleural effusion | Mycobacterium tuberculosis | Gemmatimonas aurantiaca/biochemical tests | INH, RFP, STM for 2 months; improved | NA |
Alcaide et al., 2004 | 55/M/USA | Cutaneous T-cell lymphoma, AIDS | Fever, cough, fatigue, for 2 weeks | Cavity, bilateral infiltrates | Mycobacterium | Tsukamurella sp./biochemical tests | CPF, RFB for 12 weeks; cured | NA |
Perez et al., 2008 | 71/M/USA | None | Fever, cough, hemoptysis for 3 months | Cavitary mass | Mycobacterium | T. pulmonis/biochemical tests | RFB, LVF for 6 months; cured | NA |
Maalouf et al., 2009 | 76/M/USA | Non-Hodgkin lymphoma, COPD | Fever, cough, fatigue, for 4 days | Bilateral infiltrates | Streptococcus pneumoniae | T. pulmonis/biochemical tests, 16S rRNA sequencing | MEP, VCM for 10 days; symptoms decreased | CPFX and RFP for 4 months; improved |
Menard et al., 2009 | 54/M/France | Lung transplant 4 years ago | Cough for 10 days | NR | Gram-positive bacilli | T. tyrosinosolvens/16S rRNA and hsp65 sequencing | IPM, TOB; symptoms decreased | NA |
Inchingolo et al., 2010 | 76/F/Italy | COPD, diabetes mellitus, bilateral glaucoma. | Altered state of consciousness, dyspnea for 2 days | Ground-glass opacities, infiltrates, pleural effusion | Staphylococcus epidermidis | T. pulmonis/16S rRNA sequencing | AMP/CVA, AZM→AMP/CVA, CPF; symptoms decreased | CPFX for 10 days, cured |
Mehta et al., 2011 | 79/M/USA | Coronary artery disease, atrial fibrillation | Fever, cough, bloody tinge for 10 days | Infiltrate | Mycobacterium sp. | Tsukamurella sp./HPLC | First-line CTR, AZM/ NE; second-line INH, RFP, EMB, PZA, AZM/NE | CPFX and AZM, improved |
Chen et al., 2016 | 75/M/Taiwan | Diabetes mellitus, COPD | Fever, cough, general malaise for 1 week | Infiltrate | Nocardia sp. | T. tyrosinosolvens/biochemical tests, 16S rRNA sequencing | First- line CTR, AZM for 1 week, treatment failure; second-line IPM for 3 weeks, STM for 4 weeks; condition improved | INH; EB; and RFP for 12 months, improved |
Yang et al., 2017 | 24/F/Unknown | None | Fever, cough, hemoptysis | Cavity, infiltrated mass | Mycobacterium tuberculosis | T. paurametabora/16S rRNA sequencing | First-line standard antituberculosis treatment, symptoms improved; second-line intensive antituberculosis therapy for 20 days; treatment failure | LNZ for 3 weeks, improved |
This study | 81/F/Japan | NTM-PD | Cough, hemoptysis for years | Bilateral centrilobular nodules, bronchiectasis | Rapidly growing mycobacterium | Tsukamurella sp. nov./WGS | ERY 20 years, slow progress | NA |
*Full reference lists for Tukamurella pulmonary disease reported cases are shown in Appendix . AMP/CVA, amoxicillin/clavulanate; AZM, azithromycin; CPF, ciprofloxacin; CTR, ceftriaxone; EMB; ethambutol; ERY, erythromycin; HPLC, high-performance liquid chromatography; hsp, heat-shock protein; INH, isoniazid; IPM, imipenem; LNZ, linezolid; LVF, levofloxacin; MEP, meropenem; NA, not available; NE, not evaluated; NTM-TB, nontuberculous mycobacteria tuberculosis; NR, not reported; PZA, pyrazinamide; RFB, rifabutin; STM, streptomycin; SMX/TMP, sulfamethoxazole/trimethoprim; TOB, tobramycin; VCM, vancomycin.; WGS, whole-genome sequencing.