Presentation
This is a case of a 34-year-old healthy female who presented to the Emergency Department with a low-grade fever, abdominal tenderness, redness, swelling and draining fluid. Two months prior to her visit to the Emergency Department, the woman had traveled to the Dominican Republic for an elective abdominal surgical procedure. Incision and drainage of the wound was performed and an aspirate of the abscess material and fluid was sent to the microbiology department for culture and diagnostic testing.Lab Testing
The culture was plated and 2 pinpoint colonies grew on the agar media. One colony was identified by Matrix-Assisted Laser Desorption/Ionization-Time of Flight (MALDI-TOF) as Streptococcus anginosus and the other colony was not able to be identified by MALDI-TOF or by the bioMerieux Vitek 2. The unidentified smaller pinpoint colony was Gram stained and was a beaded gram-positive rod. Because of the Gram reaction and morphology, the isolate was sub-cultured onto additional media for the growth of Mycobacteria, Nocardia and Aerobic Actinomyces. Small cream-colored colonies grew on 7H11 agar media (for Mycobacteria) and were Acid-Fast positive.Cause of Symptoms
The isolate was sent out to a reference laboratory for 16s sequencing and was identified as Mycobacterium abscessus. M. abscessus is a rapidly growing Mycobacteria found in the environment and can also be an opportunistic pathogen in humans.Treatment
The patient, after being hospitalized for 3 days, was released on oral doxycycline.Contact Information
Nicole Jackson, njackson@asmusa.org