Archive for June 19, 2015

Coexistence of primary adenocarcinoma of the lung and Tsukamurella infection: a case report and review of the literature.

J Med Case Rep. 2008 Jun 14;2:207.

Perez VA1, Swigris J, Ruoss SJ.

1Department of Pulmonary and Critical Care Medicine, Stanford University Medical Center, Pasteur Drive, Stanford, CA, USA.



A major diagnostic challenge in the evaluation of a cavitary lung lesion is to distinguish between infectious and malignant etiologies.


We present the case of an elderly man presenting with fever, hemoptysis and a left upper lobe cavitary lesion. Serial sputum cultures grew Tsukamurella pulmonis, a rare pathogen associated with cavitary pneumonia in immunocompromised patients. However, despite clinical improvement with antibiotic therapy targeted to the organism, concomitant discovery of a papillary thyroid carcinoma led to a needle biopsy of the cavitary lesion, which showed evidence of primary lung adenocarcinoma.


This is the first description of Tsukamurella infection in the setting of primary lung carcinoma. The report also illustrates the potential complex nature of cavitary lesions and emphasizes the need to consider the coexistence of malignant and infectious processes in all patients, especially those with risk factors for malignancy that fail to improve on antibiotic therapy.



June 19, 2015 at 3:04 pm

Catheter-related bloodstream infection by Tsukamurella inchonensis in an immunocompromised patient.

J Clin Microbiol. 2014 Jun;52(6):2251-3.

Takebe I1, Sawabe E1, Ohkusu K2, Tojo N1, Tohda S3.

1Department of Clinical Laboratory, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan.

2Department of Microbiology, Regeneration and Advanced Medical Science, Gifu University Graduate School of Medicine, Gifu, Japan.

3Department of Clinical Laboratory, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan


We report a case of catheter-related bloodstream infection by Tsukamurella inchonensis, identified using 16S rRNA gene sequencing, in a patient with myelofibrosis who underwent a bone marrow transplant.

Tsukamurella species infections are rare. To our knowledge, this is the first case of T. inchonensis bloodstream infection in an immunocompromised patient.


June 19, 2015 at 3:01 pm

Identification and characterization of non-tuberculous mycobacteria isolated from tuberculosis suspects in Southern-central China.

PLoS One. 2014 Dec 2;9(12):e114353.

Yu XL1, Lu L1, Chen GZ1, Liu ZG1, Lei H1, Song YZ2, Zhang SL3.

1School of Biology and Pharmaceutical Engineering, Wuhan Polytechnic University, Wuhan, China.

2Shanghai public health clinical center, Shanghai, China.

3Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.


The incidence of non-tuberculous mycobacteria (NTM)-related death has increased globally recently.

To obtain information of the species and characterization of pathogens involved in NTM pulmonary infection in Southern-central China, we identified 160 non-tuberculous infection cases from 3995 acid-fast bacilli (AFB)-positive tuberculous suspects.

We then randomly selected 101 non-tuberculous patients, isolated bacteria from their sputa and genotyped the pathogens using the 16S rRNA gene and 16S-23S rRNA internal transcribed spacer sequences.

M. intracellulare (32.67%, 33/101), M. abscessus (32.67%, 33/101) and M. fortuitum (7.92%, 8/101) are identified in these isolates. Surprisingly, non-mycobacteria including Gordonia (8.91%, 9/101), Nocardia (5.94%, 6/101) and Tsukamurella (0.99%, 1/101) are also discovered, and the case of Tsukamurella pulmonis infection is first discovered in Southern-central China.

Moreover, species of M. mucogenicum group, M. chubuense, M. kansasii, M. gastri, M. avium, M. porcinum and M. smegmatis are identified.

In addition, nine immune compromised cases (8.91%, 9/101), including type two diabetes mellitus and HIV/AIDS are found to be infected with non-tuberculous bacteria.

This study revealed the distribution and characteristics of non-tuberculous AFB pathogen infection occurred in Southern-central China, and suggested that physicians should be alert of the emerging of NTM and non-mycobacteria infection in AFB positive cases and take caution when choosing chemotherapy for tuberculosis-like pulmonary infections.

Generally, this study may help with the development of new strategy for the diagnosis and treatment of mycobacterial infection.


June 19, 2015 at 2:58 pm

Central venous catheter-related bacteremia due to Tsukamurella species in the immunocompromised host: a case series and review of the literature.

Clin Infect Dis. 2002 Oct 1;35(7):e72-7.

Schwartz MA1, Tabet SR, Collier AC, Wallis CK, Carlson LC, Nguyen TT, Kattar MM, Coyle MB.

1Department of Medicine, Division of Infectious Diseases, University of Washington, Seattle, WA, USA.


We report 6 cases of bacteremia due to Tsukamurella species, all of which were in immunosuppressed patients with indwelling central venous catheters (CVCs).

Fewer than 20 cases of serious illness due to these gram-positive bacilli have been reported in the medical literature; these cases have mostly been ascribed to the species Tsukamurella paurometabola.

Tsukamurella species are frequently misidentified as Rhodococcus or Corynebacterium species. We used high-performance liquid chromatography to identify these organisms to the genus level and 16S ribosomal RNA gene sequencing and DNA-DNA dot blots for species identification.

Three of our isolates were identified as Tsukamurella pulmonis, 1 was identified as Tsukamurella tyrosinosolvans, and 1 was identified as a unique species. One isolate was not maintained long enough for species identification.

All patients were successfully treated with antimicrobial therapy and CVC removal. Infection with this organism should be considered in the immunosuppressed patient with an indwelling CVC and gram-positive bacilli in the blood.


June 19, 2015 at 2:55 pm


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