{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T01:13:16Z","timestamp":1792199596937,"version":"4.4.0"},"reference-count":10,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["ASM Case Rep"],"published-print":{"date-parts":[[2025,9,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:sec>\n                      <jats:title>Background<\/jats:title>\n                      <jats:p>\n                        <jats:italic toggle=\"yes\">Mycobacterium intracellulare<\/jats:italic>\n                        subsp.\n                        <jats:italic toggle=\"yes\">chimaera<\/jats:italic>\n                        infective endocarditis associated with contaminated heater-cooler units has been well documented, leading to the discontinuation of these devices in most hospitals by 2018. The rarity of this infection and its nonspecific symptoms often result in delayed diagnosis.\n                      <\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                      <jats:title>Case Summary<\/jats:title>\n                      <jats:p>\n                        We describe a 56-year-old female diagnosed with\n                        <jats:italic toggle=\"yes\">M. intracellulare<\/jats:italic>\n                        subsp.\n                        <jats:italic toggle=\"yes\">chimaera<\/jats:italic>\n                        infective endocarditis with disseminated intracranial abscess 7 years after aortic and mitral valve replacement. Diagnosis was achieved using cell-free microbial DNA next-generation sequencing (cfmNGS). She underwent left temporal craniotomy for abscess drainage and aortic and mitral valve replacement. Diagnosis was confirmed via mycobacterial culture from blood, brain tissue, and explanted valve tissue. Treatment included rifabutin, ethambutol, azithromycin, and amikacin, alongside a prednisone taper prescribed for a previously diagnosed undifferentiated inflammatory process. Amikacin was discontinued 6 weeks after valve surgery because of unilateral hearing loss. She remained clinically stable 5 months after valve surgery.\n                      <\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                      <jats:title>Conclusion<\/jats:title>\n                      <jats:p>\n                        This case highlights that\n                        <jats:italic toggle=\"yes\">M. intracellulare<\/jats:italic>\n                        subsp.\n                        <jats:italic toggle=\"yes\">chimaera<\/jats:italic>\n                        infections may continue to emerge years after heater-cool unit discontinuation, suggesting that the time window for case incidence may still be active. cfmNGS may serve as a valuable diagnostic tool for disseminated\n                        <jats:italic toggle=\"yes\">M. intracellulare<\/jats:italic>\n                        subsp.\n                        <jats:italic toggle=\"yes\">chimaera<\/jats:italic>\n                        . Finally, we discuss pharmacotherapeutic factors, including the need for multiple agents over long durations, in this case with specific considerations given to the dissemination of infection into the central nervous system and potential drug-drug interactions, including steroids.\n                      <\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/asmcr.00003-25","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T09:00:21Z","timestamp":1748595621000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":3,"title":["Delayed diagnosis of disseminated\n                    <i>Mycobacterium intracellulare<\/i>\n                    subsp.\n                    <i>chimaera<\/i>\n                    infective endocarditis via cell-free metagenomic next-generation sequencing: a case report"],"prefix":"10.1128","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2461-2752","authenticated-orcid":false,"given":"Joseph Benigno","family":"Ladines-Lim","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Penn Medicine, University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Teng","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Penn Medicine, University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Tebas","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Penn Medicine, University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"O'Donnell","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Penn Medicine, University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Koenig","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Penn Medicine, University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Kreider","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Penn Medicine, University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Dyer","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Penn Medicine, University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Anwar","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01s8dqw53","id-type":"ROR","asserted-by":"publisher"}],"name":"West Virginia School of Osteopathic Medicine","place":["Lewisburg, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Rodriguez","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00b30xv10","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pharmacy, Penn Medicine, University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonal","family":"Patel","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00b30xv10","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pharmacy, Penn Medicine, University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Rodino","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurel","family":"Glaser","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Richterman","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Penn Medicine, University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2019.10.009"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofae688"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000942"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPNM3J9TOIBRSK"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.121.057951"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-pathmechdis-012418-012751"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2023.1227537"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.972280"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.01855-22"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac287"}],"container-title":["ASM Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/asmcr.00003-25","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/asmcr.00003-25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T17:29:40Z","timestamp":1757438980000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/asmcr.00003-25"}},"subtitle":[],"editor":[{"given":"Carey-Ann 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