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October 1984

[ill]isseminated Disease due to [ill]ycobacterium chelonei Treated [ill]ith Amikacin and Cefoxitin: [ill]bsence of Killing With Either Agent and [ill]ssible Role of Granulocytes in [ill]linical Response

Author Affiliations

From the Infectious Disease (Dr Carpenter) and Oncology (Dr Troxell) [ill]vice, Department of Medicine, Brooke Army Medical Center, Fort Sam [ill]uston, Tex, and the Department of Microbiology (Dr Wallace), University Texas Health Center at Tyler.

Arch Intern Med. 1984;144(10):2063-2065. doi:10.1001/archinte.1984.04400010188033

• Disseminated disease due to rapidly growing mycobac[ill]ia is manifested by positive blood cultures and multiple skin [ill]d subcutaneous abscesses. A patient had T-cell lymphoma [ill]d disseminated disease; he also had neutropenla intermit[ill]tly. Single-agent therapy with amikacin sulfate or cefoxitin [ill]dium was not adequate during periods of neutropenia, and [ill]mbination therapy was necessary to control the infection. [ill]nical response correlated with detectable serum inhibitory [ill]els of the antimicrobial agents. Surprisingly, the organism [ill]s not killed by either amikacin or cefoxitin, a finding that [ill]rrelated with the absence of serum bactericidal levels. This [ill]se suggests that granulocytes may play a role in the host's [ill]sponse to this organism, and determination of serum inhib[ill]ry and possible bactericidal levels may be useful in monitor[ill] therapy.

(Arch Intern Med 1984;144:2063-2065)