Bloodstream Infection Caused by Non-Tuberculous Mycobacteria in a Chronic Dialysis Patient: Case Report

Central venous catheter-related bloodstream infections represent a significant public health problem, associated with high hospitalization rates and morbidity and mortality. This scenario is particularly critical among patients with chronic kidney disease on dialysis, who often depend on central venous catheters. Among the less frequent agents involved, Mycobacterium brisbanense stands out, a rapidly growing mycobacterium rarely isolated in dialysis patients. We report a case caused by this agent in a patient using a long-term central venous catheter. A 64-year-old male, mized-race, born and residing in Salvador (BA), with chronic kidney disease on continuous dialysis therapy via a central venous catheter in the left femoral vein since 11/2024. Medical history included insulin-dependent type 2 diabetes mellitus, systemic arterial hypertension, and dyslipidemia. In the second half of March 2025, he developed fever, chills, nausea, vomiting, and anorexia during hemodialysis sessions. Empirical antibiotic therapy with vancomycin was initiated at a satellite clinic, without clinical response. Blood culture collected on 03/24/2025 revealed growth of Mycobacterium brisbanense. He was referred to a tertiary hospital on 04/03/2025 and started antimicrobial therapy with amikacin, levofloxacin, and trimethoprim-sulfamethoxazole, according to Infectious Diseases guidance, with a planned six-week course, including two weeks of inpatient treatment. Complementary exams (contrast-enhanced angiotomography of cervical, thoracic, abdominal, and pelvic regions, and transthoracic echocardiography) did not identify an infectious focus compatible with mycobacteriosis. The patient remained clinically stable, without dialysis complications. The catheter was removed on 04/11/2025, with subsequent placement of a new access in the left femoral vein. He was discharged on 04/22/2025, with outpatient follow-up and continuation of antibiotic therapy. The rarity of reports in the literature makes clinical suspicion and definition of diagnostic and therapeutic approaches difficult in infections caused by M. brisbanense, reinforcing the importance of further studies and clinical descriptions to support recognition of this agent as an opportunistic pathogen in dialysis patients.