Successful treatment of pulmonary Mycobacterium xenopi infection in a natural killer cell-deficient patient with clarithromycin, rifabutin, and sparfloxacin

Isolation of Mycobacterium xenopi from the respiratory tract may indicate p neumonia, often clinically indistinguishable from tuberculosis. Resistance to the classic antituberculous drugs renders the treatment of these infecti ons problematic. We report on a case of cavernous pneumonia caused by M. xe nopi in a 36-year-old male with natural killer cell deficiency but without severe immunodeficiency. He was successfully treated with a novel triple-dr ug combination comprising clarithromycin, sparfloxacin, and rifabutin. An i mpressive subsequent regression of pathological pulmonary changes was obser ved, and mycobacteria could no longer be detected. The therapeutic potentia l of clarithromycin and sparfloxacin in the treatment of M. xenopi infectio ns is discussed.