Medical Management for the Treatment of Nontuberculous Mycobacteria Infection of the Parotid Gland: Avoiding Surgery May Be Possible

Infection with nontuberculous mycobacteria (NTM) is uncommon in the head and neck; therefore there is no clear consensus on treating these infections. Our objective was to report our experience with a unique case of NTM infection of the parotid in an immunocompetent patient, in order to determine ap...

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Main Authors: Emily Kay-Rivest, Sarah Bouhabel, Matthew Thomas Oughton, Michael Peter Hier
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2016/4324525
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author Emily Kay-Rivest
Sarah Bouhabel
Matthew Thomas Oughton
Michael Peter Hier
author_facet Emily Kay-Rivest
Sarah Bouhabel
Matthew Thomas Oughton
Michael Peter Hier
author_sort Emily Kay-Rivest
collection DOAJ
description Infection with nontuberculous mycobacteria (NTM) is uncommon in the head and neck; therefore there is no clear consensus on treating these infections. Our objective was to report our experience with a unique case of NTM infection of the parotid in an immunocompetent patient, in order to determine appropriate management through our experience with this pathology. A 57-year-old man, known for numerous comorbid diseases, presented to our institution complaining of right parotid swelling and pain. A computed tomography (CT) of the neck showed a multiloculated collection in the inferior portion of the right parotid gland, compatible with abscess formation. This abscess was drained by interventional radiology (IR) but required repeat drainage twice due to lack of initial improvement. He was treated with several antibiotics as culture results initially indicated Gram-positive bacilli and then Mycobacterium species, with final identification by a reference laboratory as Mycobacterium abscessus. Imipenem was initiated with amikacin and clarithromycin. His infection clinically and radiologically resolved after 5 months of antibiotherapy. In our case, the patient improved following intravenous antibiotic therapy. Our experience demonstrates that appropriate antibiotherapy can lead to resolution of Mycobacterium abscessus infection in the parotid without the risks associated with surgical intervention.
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spelling doaj-art-e7dd4cff16b641698d89674fbe2ad63e2025-08-20T02:22:15ZengWileyCase Reports in Medicine1687-96271687-96352016-01-01201610.1155/2016/43245254324525Medical Management for the Treatment of Nontuberculous Mycobacteria Infection of the Parotid Gland: Avoiding Surgery May Be PossibleEmily Kay-Rivest0Sarah Bouhabel1Matthew Thomas Oughton2Michael Peter Hier3Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, QC, H3T 1E2, CanadaDepartment of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, QC, H3T 1E2, CanadaDepartment of Medicine, Division of Infectious Diseases, Jewish General Hospital, McGill University, Montreal, QC, H3T 1E2, CanadaDepartment of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, QC, H3T 1E2, CanadaInfection with nontuberculous mycobacteria (NTM) is uncommon in the head and neck; therefore there is no clear consensus on treating these infections. Our objective was to report our experience with a unique case of NTM infection of the parotid in an immunocompetent patient, in order to determine appropriate management through our experience with this pathology. A 57-year-old man, known for numerous comorbid diseases, presented to our institution complaining of right parotid swelling and pain. A computed tomography (CT) of the neck showed a multiloculated collection in the inferior portion of the right parotid gland, compatible with abscess formation. This abscess was drained by interventional radiology (IR) but required repeat drainage twice due to lack of initial improvement. He was treated with several antibiotics as culture results initially indicated Gram-positive bacilli and then Mycobacterium species, with final identification by a reference laboratory as Mycobacterium abscessus. Imipenem was initiated with amikacin and clarithromycin. His infection clinically and radiologically resolved after 5 months of antibiotherapy. In our case, the patient improved following intravenous antibiotic therapy. Our experience demonstrates that appropriate antibiotherapy can lead to resolution of Mycobacterium abscessus infection in the parotid without the risks associated with surgical intervention.http://dx.doi.org/10.1155/2016/4324525
spellingShingle Emily Kay-Rivest
Sarah Bouhabel
Matthew Thomas Oughton
Michael Peter Hier
Medical Management for the Treatment of Nontuberculous Mycobacteria Infection of the Parotid Gland: Avoiding Surgery May Be Possible
Case Reports in Medicine
title Medical Management for the Treatment of Nontuberculous Mycobacteria Infection of the Parotid Gland: Avoiding Surgery May Be Possible
title_full Medical Management for the Treatment of Nontuberculous Mycobacteria Infection of the Parotid Gland: Avoiding Surgery May Be Possible
title_fullStr Medical Management for the Treatment of Nontuberculous Mycobacteria Infection of the Parotid Gland: Avoiding Surgery May Be Possible
title_full_unstemmed Medical Management for the Treatment of Nontuberculous Mycobacteria Infection of the Parotid Gland: Avoiding Surgery May Be Possible
title_short Medical Management for the Treatment of Nontuberculous Mycobacteria Infection of the Parotid Gland: Avoiding Surgery May Be Possible
title_sort medical management for the treatment of nontuberculous mycobacteria infection of the parotid gland avoiding surgery may be possible
url http://dx.doi.org/10.1155/2016/4324525
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