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Choi, Kang, Jeong, Lim, Choe, Hwang, Park, Hwangbo, and Lee: First Isolation of Segniliparus rugosus from a Patient with Radiologic Features Similar to Non-Tuberculous Mycobacteriosis
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2012; 72(1): 82-87.

Published online: 30 January 2012

DOI: https://doi.org/10.4046/trd.2012.72.1.82

First Isolation of Segniliparus rugosus from a Patient with Radiologic Features Similar to Non-Tuberculous Mycobacteriosis

Sun Mi Choi, M.D.1, Hyo Jae Kang, M.D.1, Yun Jeong Jeong, M.D.1, Joo Hyun Lim, M.D.1, Won Seok Choe, M.D.1, Sang-Hyun Hwang, M.D., Ph.D.2, Jinkyeong Park, M.D.3, Bin Hwangbo, M.D., Ph.D.3, Hee Seok Lee, M.D.3

1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

2Department of Laboratory Medicine, National Cancer Center, Goyang, Korea.

3Center for Lung Cancer, National Cancer Center, Goyang, Korea.

Address for correspondence: Hee Seok Lee, M.D. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Center for Lung Cancer, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang 410-769, Korea. Phone: 82-31-920-1749, Fax: 82-31-920-1520, jekyde@yahoo.co.kr

Received 29 August 2011       Revised 1 September 2011       Accepted 16 September 2011

Copyright © 2012. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

In 2005, a group of mycolic acid-containing bacteria was characterized as belonging to a novel genus, Segniliparus with species Segniliparus rugosus and S. rotundus. We report a case of the S. rugosus isolated from a 54-year-old woman with radiologic features mimicking that of non-tuberculous mycobacteriosis (NTM). When the patient first visited our hospital, an acid-fast bacteria (AFB) smear tested positive and Mycobacterium tuberculosis polymerase chain reaction (TB PCR) was negative in the bronchoalveolar lavage sample. After 2 months, the growing colonies were reported as NTM, but could not be identified because they had died. One year after the initial visit, induced sputum samples showed the same results, positive AFB smear and negative TB PCR. At this point, the growing colonies were identified as S. rugosus. Therefore, we should consider Segniliparus genus as a differential diagnosis for AFB in respiratory specimens in addition to the genus Mycobacterium.

Keywords: Actinomycetales

Figures and Tables

Figure 1
Chest X-ray images. (A) Chest X-ray taken 7 months before the first OPD visit showed parenchymal infiltration in the left middle lung field. (B) Chest X-ray taken during the first visit showed persistent parenchymal infiltration in left middle lung field. OPD: outpatient department.
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Figure 2
Chest HRCT images taken during the first visit revealed small nodules and branching centrilobular opacities in the left lingular segment (A), RML (B, C) and consolidation containing air bronchogram in the left lingular segment (B, C) and RML (D). HRCT: high resolution computed tomography; RML: right middle lobe.
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Figure 3
Chest CT images taken 12 months after the first visit showed new branching centrilobular opacities in the left lower lobe (A, arrow) and persitent bronchiolitis and bronchiectatic features in the left lingular segment (B, C), RML (C, D). CT: computed tomography; RML: right middle lobe.
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Figure 4
AFB stains (Ziehl-Neelsen stains) of induced sputum specimens (×1,000). AFB stains showed numerous acid fast bacilli, Segiliparus rugosus, which were later confirmed by 16s rRNA sequencing.
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References

1. Butler WR, Floyd MM, Brown JM, Toney SR, Daneshvar MI, Cooksey RC, et al. Novel mycolic acid-containing bacteria in the family Segniliparaceae fam. nov., including the genus Segniliparus gen. nov., with descriptions of Segniliparus rotundus sp. nov. and Segniliparus rugosus sp. nov. Int J Syst Evol Microbiol. 2005. 55:1615–1624.
2. Butler WR, Sheils CA, Brown-Elliott BA, Charles N, Colin AA, Gant MJ, et al. First isolations of Segniliparus rugosus from patients with cystic fibrosis. J Clin Microbiol. 2007. 45:3449–3452.
3. Butler WR, Floyd MM, Silcox V, Cage G, Desmond E, Duffey PS, et al. Standardized method for HPLC identification of Mycobacteria. 1996. Atlanta, GA: CDC, US Department of Health and Human Services.
4. Floyd MM, Gross WM, Bonato DA, Silcox VA, Smithwick RW, Metchock B, et al. Mycobacterium kubicae sp. nov., a slowly growing, scotochromogenic Mycobacterium. Int J Syst Evol Microbiol. 2000. 50:1811–1816.
5. Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F, et al. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med. 2007. 175:367–416.
6. Hansen T, Van-Kerckhof J, Jelfs P, Wainwright C, Ryan P, Coulter C. Segniliparus rugosus infection, Australia. Emerg Infect Dis. 2009. 15:611–613.
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