Mycobacterium Chimaera. A Lethal Enemy of Cardiac Surgery

Abstract

Mycobacterium chimaera (M. chimaera) can cause disseminated infection and Infective Endocarditis (IE) in patients with previous cardiac surgery. M. chimaera is acquired during cardiopulmonary bypass via bioaerosols emitted from contaminated heater-cooler units water systems. M. chimaera infections can cause pneumonia, especially in patients with underlying chronic pulmonary diseases like cystic fibrosis and Chronic Obstructive Pulmonary Disease (COPD), cardiovascular manifestations and disseminated mycobacterial infection. The prognosis is extremely poor and early diagnosis and treatment are decisive to avoid fatality. Nevertheless, an early diagnosis is difficult due to intermittent bacteremia and normal echocardiography and it requires a high index of suspicion. An early use of FDG PET/CT could improve an accurate diagnosis and reduce morbidity and mortality. We report an illustrative case of a M. chimaera IE with disseminated infection in a patient suffering from COPD who underwent heart surgery.