Tuberc Respir Dis.  2012 Jan;72(1):82-87.

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

• Choi SM
• Kang HJ
• Jeong YJ
• Lim JH
• Choe WS
• Hwang SH
• Park J
• Hwangbo B
• Lee HS

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.

Keyword

Actinomycetales

MeSH Terms

Actinomycetales
Bacteria
Bronchoalveolar Lavage
Diagnosis, Differential
Female
Humans
Middle Aged
Mycobacterium
Mycobacterium tuberculosis
Polymerase Chain Reaction
Sputum

Figure

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  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.

Reference

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