Mycobacterium abscessus Pulmonary Disease in a Myasthenia Gravis Patient: A Case Report.

Abstract

There is limited guidance on managing Mycobacterium abscessus pulmonary disease in Myasthenia Gravis patients. Macrolides and aminoglycosides form the backbone of M. abscessus pulmonary disease treatment but are avoided in Myasthenia Gravis patients due to the risk of precipitating myasthenic crisis. A 29-year-old female, with a history of anti-acetylcholine receptor antibody-positive Myasthenia Gravis and bronchiectasis, was diagnosed with M. abscessus pulmonary disease. She was commenced on a macrolide-based regime safely with close monitoring, pretreatment with intravenous immunoglobulin (1 g/kg),10 mg prednisolone, 500 mg rituximab and augmentation of the neuromuscular junction with pyridostigmine and 3,4-Diaminopyridine. She was safely discharged to the hospital in the home program and achieved clinical, radiological and microbiological response.