Cure of Polymicrobial Mycobacterium Abscessus and Chelonae Endocarditis Through Integrated Medical and Addiction Treatment

We present here a case of tricuspid valve endocarditis in a person who injects drugs (PWID) with Mycobacterium chelonae and Mycobacterium abscessus successfully treated with a combined medical and surgical approach. This case highlights multiple challenges faced in the cases of treating injection drug use endocarditis including delays in identification and diagnosis of mycobacterial organisms, concern for intravenous line manipulation, poly microbial endocarditis which can be difficult to detect, and need for patients to be admitted for prolonged periods. A systematic literature review of M. abscessus endocarditis is provided with parallels and teaching points between our case and the 14 additional reported cases identified, particularly our approach to addiction treatment in order to facilitate cure in this patient.

Keywords: Endocarditis, Mycobacterium, Injection Drug Use, Integrated Care