Fatal pulmonary infection due to multidrug-resistant Mycobacterium abscessus in a patient with cystic fibrosis

We report a case of fatal pulmonary infection caused by Mycobacterium absce ssus in a young patient with cystic fibrosis, who underwent bipulmonary tra nsplantation after a 1-year history of severe lung disease. Fifteen days af ter surgery he developed septic fever with progressive deterioration in lun g function. M. abscessus, initially isolated from a pleural fluid specimen, was then recovered from repeated blood samples, suggesting a disseminated nature of the mycobacterial disease. Drug susceptibility testing assay, per formed on two sequential isolates of the microorganism, showed a pattern of multidrug resistance. Despite aggressive therapy with several antimycobact erial drugs, including clarithromycin, the infection persisted, and the pat ient died.