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Volume 42, Number 6, December 2009

Bilateral parotitis caused by Mycobacterium chelonae in an immunocompetent child 


Szu-Hung Chu, Shyh-Dar Shyur, Yi-Lei Wu, Kuo-Ming Chang, Huei-Chung Lee


Received: December 15, 2008    Revised: January 6, 2009    Accepted: February 10, 2009   

 

Corresponding author:

dr. Shyh-Dar Shyar, 92. Sec. 2, Chung Shan North Rd, Taipei, Taiwan. E-mail: a4525@ms7.mmh.org.tw



 

Background and purpose: 

This report is of a healthy 3-year-old boy with bilateral parotitis caused by Mycobacterium chelonae. He was treated with antibiotics, but the symptoms did not improve. The biopsy pathology report revealed chronic caseating granulomatous inflammation. After 2 weeks, Mycobacterium chelonae was identified from the biopsy specimen culture. The antibiotics were changed to amikacin and clarithromycin, according to the susceptibility test. Two weeks later, he underwent debridement surgery. Only partial excision of the infected tissue was performed because of the possibility of facial nerve injury. After another 2 weeks of treatment with amikacin and clarithromycin, parotidectomy was performed. The patient then received a 6-month course of oral clarithromycin. At the 1-year follow up, he was well and without residual mass. His immunologic examinations were all within normal limits. This is the first report of bilateral parotitis caused by Mycobacterium chelonae in an immunocompetent boy in the English-language literature.



 

Key words:

Amikacin; Clarithromycin; Debridement; Mycobacterium; Mycobacterium chelonae; Parotitis