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Recurrent Mycobacterium avium Complex Infection: An Unlikely Cause

Grippen Goddard, Amanda DO; Bathla, Girish MBBS, FRCR; Petts, Jennifer DO; Ballas, Zuhair K. MD

Infectious Diseases in Clinical Practice: March 2017 - Volume 25 - Issue 2 - p e6–e8
doi: 10.1097/IPC.0000000000000463
Case Report

Abstract: A 64-year-old white female presented with 4 years of episodic, productive cough, fevers, chills, night sweats, and weight loss. Over this period, she had documented recurrent Mycobacterium avium complex in the bronchiolar lavage and sputum despite taking antibiotics for 2 years. Result of extensive immune evaluation including genetic testing was negative. Physical examination revealed dentures covered in a gray film. Cultures taken from the dentures grew Mycobacterium avium complex. The patient's symptoms, inflammatory markers, and chest imaging significantly improved after removing the dentures. Additionally, the sputum cultures became negative. Biofilms are known to be detrimental to public health via colonization of medical devices or naturally occurring reservoirs in the human body. This case highlights important clinical points: the necessity of taking a thorough history and physical examination, considering dentures as foreign bodies, especially if pulmonary infections recur, and the difficulty of treating biofilms short of removing the reservoir.

Biofi lms are known to be detrimental to public health via colonization of medical devices or naturally occurring reservoirs in the human body. Dentures are not commonly regarded as foreign bodies and may be missed on the physical exam. This case demonstrates the importance of routinely examining and culturing dentures especially if pulmonary infections recur. To the authors' knowledge, this is the fi rst report of Mycobacterium avium complex isolates from dentures leading to seeding and chronic pulmonary infections.

From the Departments of *Internal Medicine, and †Radiology, University of Iowa Hospitals and Clinics and the Iowa City VA Medical Center, Iowa City; and ‡The Iowa Clinic, West Des Moines, IA.

Correspondence to: Amanda Grippen Goddard, DO, Department of Internal Medicine, University of Iowa Hospitals and Clinics and the Iowa City VA Medical Center, Iowa City. E-mail: amanda-grippen@uiowa.edu.

The authors have no funding or conflicts of interest to disclose.

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