A rare case of non-tuberculous mastitis

Latha Sarma, Asmath Qureshi, Kapil Alias Mohit Chilana, Nandan Putti

Pdf Page Numbers :- 115-117

 Latha Sarma^1,*, Asmath Qureshi¹, Kapil Alias Mohit Chilana¹ and Nandan Putti¹

¹Department of Pulmonology, Krishna Institute of Medical Sciences, Minister Road, Secunderabad-500003, Telangana, India

*Corresponding author: Dr. Latha Sarma, Critical respiratory & Sleep specialist, Department of Pulmonology, Krishna Institute of Medical Sciences, Minister Road, Secunderabad-500003, Telangana, India. Email: dr.lathasarma@gmail.com

Received 05 April 2016; Revised 29 May 2015; Accepted 16 June 2015; Published 28 June 2016

Citation: Sarma L, Qureshi A, Chilana KAM, Putti N. A rare case of non-tuberculous mastitis. J Med Sci Res. 2016; 4(3):115-117. DOI: http://dx.doi.org/10.17727/JMSR.2016/4-028

Copyright: © 2016 Sarma L, et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

 A 15-year-old girl presented with left breast lump with purulent discharge. During the last three months she lost 4 kg weight. There was evening rise of temperature which was not associated with joint pains or chills. She had received three courses of antibiotics earlier in the other healthcare center, with no response. Ultrasound scan showed multiple cutaneous sinuses and FNA report findings were suggestive of chronic granulomatous mastitis. As the patient was not responding to multiple antibiotics courses, HRZE (Anti Tubercular Treatment, ATT) was started. But after three months of ATT she developed multiple sinus tracts filled with fluid and with superficial ulcerations, which was aspirated, sent for analysis and oral Moxifloxacin 400 mg was added. DNA based line probe assay detected Non Tuberculous mycobacterium (NTM) and was referred for NTM species identification. Molecular genetics assay identified Mycobacterium chelonae/ Mycobacterium immunogenum species and HRZE regimen was stopped. Patient was started on oral clarithromycin, linezolid according to sensitivity report. She responded well and repeat ultrasound scan showed significant resolution of the sinus and there was no discharge. NTM should be considered for breast infections that recur despite standard antibiotic therapy or ATT.

Keywords: nontuberculous mastitis; anti tubercular therapy; antibiotics; young female