case_images: PMC8046554_01
case_images: Computed tomography of the chest demonstrating large bilateral perihilar opacities at presentation.
case_images: CRIID2021-6615722.001.jpg
case_images: PMC8046554_01_CRIID2021-6615722.001.jpg
case_images: fig1
case_images: Pediatric Pulmonology service was consulted and computed tomography scan of the chest showed large posterior bilateral perihilar opacities with sparing of pulmonary periphery and bases, with subcarinal lymphadenopathy (Figure 1). Purified protein derivative (PPD) skin test and
case_images: (a) Mycobacterium abscessus antibiotic susceptibilities for our patient as reported from UT Health Science Center at Tyler. (b) Patient's M. abscessus antibiotic susceptibilities reported from local microbiology laboratory.
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case_images: PMC8046554_01_CRIID2021-6615722.002.jpg
case_images: fig2
case_images: As inducible macrolide resistance for M. abscessus isolates has been reported, imipenem-cilastatin (20 mg/kg/dose q12 h) was initiated despite the isolate's MIC reported to be >32 mug/mL, while awaiting erm(41) gene testing results performed at the Mycobacteria/Nocardia lab at the University of Texas Health Science Center at Tyler. A nonfunctional erm(41) gene was identified by sequencing, confirming clarithromycin susceptibility (Figure 2).