Volume 28, Number 7—July 2022
Dispatch
Chronic Pulmonary Disease Caused by Tsukamurella toyonakaense
Tomoki Kuge, Kiyoharu Fukushima
, Yuki Matsumoto, Haruko Saito, Yuko Abe, Eri Akiba, Kako Haduki, Tadayoshi Nitta, Akira Kawano, Michio Tanaka, Yumi Hattori, Takahiro Kawasaki, Takanori Matsuki, Takayuki Shiroyama, Daisuke Motooka, Kazuyuki Tsujino, Keisuke Miki, Masahide Mori, Seigo Kitada, Shota Nakamura, Tetsuya Iida, Atsushi Kumanogoh, and Hiroshi Kida
, Yuki Matsumoto, Haruko Saito, Yuko Abe, Eri Akiba, Kako Haduki, Tadayoshi Nitta, Akira Kawano, Michio Tanaka, Yumi Hattori, Takahiro Kawasaki, Takanori Matsuki, Takayuki Shiroyama, Daisuke Motooka, Kazuyuki Tsujino, Keisuke Miki, Masahide Mori, Seigo Kitada, Shota Nakamura, Tetsuya Iida, Atsushi Kumanogoh, and Hiroshi Kida
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.
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