Ann Lab Med.  2012 Jul;32(4):298-303. 10.3343/alm.2012.32.4.298.

Lung Infection Caused by Mycobacterium riyadhense Confused with Mycobacterium tuberculosis: The First Case in Korea

• Choi JI
• Lim JH
• Kim SR
• Lee SH
• Park JS
• Seo KW
• Jeon JB
• Jeong J

• KMID: 1380091
• DOI: http://doi.org/10.3343/alm.2012.32.4.298

Abstract

A slowly growing, non-chromogenic mycobacterial strain was isolated from sputum and bronchial lavage fluid samples of a patient presenting with productive cough, blood-tinged sputum, low-grade fever, and weakness. A positive acid-fast bacilli sputum smear result prompted the initiation of an anti-tuberculosis regimen. Multiplex real-time PCR showed a negative result for Mycobacterium tuberculosis complex and a positive result for nontuberculous mycobacteria. The DNA chip test confirmed this organism as a member of the genus Mycobacterium, but could not specify the species. Interestingly, the mycolic acid patterns obtained by HPLC nearly overlapped with those of M. simulans. The sequences of the Mycobacterium 16S rRNA gene and 16S-23S internal transcribed spacer region were unique and were found to have 100% similarity with those of M. riyadhense. After a review of the literature, we report this case as the first Korean case of M. riyadhense lung infection.

Keyword

Nontuberculous mycobacteria; Mycobacterium; Mycobacterium riyadhense; Mycobacterium simulans

MeSH Terms

Adult
Antitubercular Agents/pharmacology
Chromatography, High Pressure Liquid
Female
Humans
Lung Diseases/*microbiology
Microbial Sensitivity Tests
Mycobacterium/classification/drug effects/*isolation & purification
Mycobacterium Infections/microbiology
Mycobacterium tuberculosis/genetics/isolation & purification
Mycolic Acids/analysis
Oligonucleotide Array Sequence Analysis
Phylogeny
RNA, Ribosomal, 16S/chemistry/genetics
RNA, Ribosomal, 23S/chemistry/genetics
Republic of Korea
Sequence Analysis, DNA

Figure

• 

  Fig. 1 HPLC pattern of strain UUH-10070721646 (right) compared with that of Mycobacterium tuberculosis (left); the HPLC pattern of UUH-10070721646 is characterized by a single, late cluster of peaks.

• 

  Fig. 2 Phylogenetic relationships of strain UUH-10070721646 and related Mycobacterium species on the basis of 16S rRNA gene sequences.

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