[ill]isseminated Disease due to [ill]ycobacterium chelonei Treated [ill]ith Amikacin and Cefoxitin

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Abstract
• 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)