PMC8046554_01
Computed tomography of the chest demonstrating large bilateral perihilar opacities at presentation.
CRIID2021-6615722.001.jpg
PMC8046554_01_CRIID2021-6615722.001.jpg
fig1
Pediatric Pulmonology service was consulted and computed tomography scan of the chest showed large posterior bilateral perihilar opacities with sparing of pulmonary periphery and bases, with subcarinal lymphadenopathy (Figure 1). Purified protein derivative (PPD) skin test and
(a) Mycobacterium abscessus antibiotic susceptibilities for our patient as reported from UT Health Science Center at Tyler. (b) Patient's M. abscessus antibiotic susceptibilities reported from local microbiology laboratory.
CRIID2021-6615722.002.jpg
PMC8046554_01_CRIID2021-6615722.002.jpg
fig2
As inducible macrolide resistance for M. abscessus isolates has been reported, imipenem-cilastatin (20 mg/kg/dose q12 h) was initiated despite the isolate's MIC reported to be >32 mug/mL, while awaiting erm(41) gene testing results performed at the Mycobacteria/Nocardia lab at the University of Texas Health Science Center at Tyler. A nonfunctional erm(41) gene was identified by sequencing, confirming clarithromycin susceptibility (Figure 2).