{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:10:36Z","timestamp":1788952236251,"version":"build-2803163510"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Mycobacterium abscessus<\/jats:italic>\n                      (\n                      <jats:italic>M. abscessus<\/jats:italic>\n                      ), a rapidly growing non-tuberculous mycobacterium (NTM), rarely causes extrapulmonary disease involving more than one serosal compartment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      An 83-year-old man developed intermittent fever about 6 weeks after coronary stent implantation. Multiple antibiotics were ineffective, and he was admitted for fever of unknown origin. Echocardiography showed newly developed pericardial adhesion with echocardiographic changes suggestive of possible early constrictive physiology. These were absent on the echocardiogram performed on the day of percutaneous coronary intervention. During admission, he underwent surgery for mechanical small-bowel obstruction, in which dense omental adhesions were found. With no prior abdominal surgery, the synchronous pericardial, pleural, and peritoneal abnormalities raised suspicion of a systemic inflammatory or infectious process. A single blood-culture draw at the outside hospital grew coagulase-negative staphylococcus, but blood cultures repeated after admission and a bone-marrow culture were negative. Blood metagenomic next-generation sequencing (mNGS) detected\n                      <jats:italic>M. abscessus<\/jats:italic>\n                      at very low abundance (three species-level reads, below the \u22658-read threshold), reported as a suspected organism. Temperature improved during the administration of agents with recognized activity against\n                      <jats:italic>M. abscessus<\/jats:italic>\n                      (linezolid, tigecycline) and relapsed during the administration of \u03b2-lactams not active against this organism. Integrating the clinical course, treatment response, and consultation from a tuberculosis specialty hospital, a clinically suspected diagnosis of\n                      <jats:italic>M. abscessus<\/jats:italic>\n                      infection supported by mNGS was made, although microbiological confirmation was not obtained. Temperature normalized on tigecycline and the patient\u2019s condition improved, and he was transferred for continued anti-NTM therapy. He was subsequently lost to follow-up, and therefore, the long-term outcome is unknown.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      We report a rare presentation of suspected\n                      <jats:italic>M. abscessus<\/jats:italic>\n                      -associated polyserositis following coronary stenting, in which mNGS provided the etiologic clue when cultures were unrevealing. NTM should be considered in older patients with unexplained fever after cardiovascular intervention. Low-abundance mNGS results, although below reporting thresholds, may be clinically meaningful when interpreted alongside the clinical course and treatment response, while remaining open to contamination and misclassification. NTM-associated myeloperoxidase-antineutrophil cytoplasmic antibody positivity is non-specific and must be distinguished from primary vasculitis.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1910932","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T10:17:22Z","timestamp":1788949042000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Suspected Mycobacterium abscessus\u2013associated polyserositis following coronary stenting, diagnosed with the aid of metagenomic next-generation sequencing"],"prefix":"10.3389","volume":"13","author":[{"given":"Yimeng","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Shengjing Hospital of China Medical University","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shengjing Hospital of China Medical University","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxia","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shengjing Hospital of China Medical University","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shengjing Hospital of China Medical University","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2294","DOI":"10.3201\/eid3011.240459","article-title":"Extrapulmonary Mycobacterium abscessus infections, France, 2012\u20132020","volume":"30","author":"Heid-Picard","year":"2024","journal-title":"Emerg Infect Dis"},{"key":"B2","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1016\/j.cmi.2023.09.019","article-title":"Antimicrobial susceptibility of Mycobacterium abscessus and treatment of pulmonary and extra-pulmonary infections","volume":"30","author":"Tunesi","year":"2023","journal-title":"Clin Microbiol Infect"},{"key":"B3","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1016\/j.cmi.2023.08.035","article-title":"Epidemiology of Mycobacterium abscessus","volume":"30","author":"Cristancho-Rojas","year":"2023","journal-title":"Clin Microbiol Infect"},{"key":"B4","doi-asserted-by":"publisher","first-page":"3247","DOI":"10.3390\/ijms26073247","article-title":"Mycobacterium abscessus virulence factors: an overview of un-explored therapeutic options","volume":"26","author":"Cocorullo","year":"2025","journal-title":"Int J Mol Sci"},{"key":"B5","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1016\/j.cmi.2024.02.019","article-title":"All you want to know about Mycobacterium abscessus","volume":"30","author":"Cambau","year":"2024","journal-title":"Clin Microbiol Infect"},{"key":"B6","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1186\/s12916-016-0606-6","article-title":"\"Why me, why now?\u201d Using clinical immunology and epidemiology to explain who gets nontuberculous mycobacterial infection","volume":"14","author":"Lake","year":"2016","journal-title":"BMC Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1053\/j.ackd.2019.01.004","article-title":"Immune dysfunction and risk of infection in chronic kidney disease","volume":"26","author":"Syed-Ahmed","year":"2019","journal-title":"Adv Chronic Kidney Dis"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1496896","DOI":"10.3389\/fcimb.2024.1496896","article-title":"Population genetic analysis of clinical Mycobacterium abscessus complex strains in China","volume":"14","author":"Li","year":"2025","journal-title":"Front Cell Infect Microbiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1136588","DOI":"10.3389\/fcimb.2023.1136588","article-title":"Microbiological diagnostic performance of metagenomic next-generation sequencing compared with conventional culture for patients with community-acquired pneumonia","volume":"13","author":"Lin","year":"2023","journal-title":"Front Cell Infect Microbiol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"972280","DOI":"10.3389\/fpubh.2022.972280","article-title":"Nontuberculous mycobacteria by metagenomic next-generation sequencing: three cases reports and literature review","volume":"10","author":"Liu","year":"2022","journal-title":"Front Public Health"},{"key":"B11","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1186\/s12890-018-0732-3","article-title":"Microscopic polyangiitis secondary to Mycobacterium abscessus in a patient with bronchiectasis: a case report","volume":"18","author":"Addy","year":"2018","journal-title":"BMC Pulm Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"108595","DOI":"10.1016\/j.clim.2020.108595","article-title":"Infection-induced myeloperoxidase specific antineutrophil cytoplasmic antibody (MPO-ANCA) associated vasculitis: a systematic review","volume":"220","author":"Kakoullis","year":"2020","journal-title":"Clin Immunol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1016\/j.mjafi.2022.09.008","article-title":"Mycobacterium abscessus causing native aortic valve endocarditis post stenting","volume":"80","author":"Sondhi","year":"2022","journal-title":"Med J Armed Forces India"},{"key":"B14","doi-asserted-by":"publisher","first-page":"ofy207","DOI":"10.1093\/ofid\/ofy207","article-title":"Disseminated Mycobacterium abscessus infection secondary to an infected vascular stent: case report and review of the literature","volume":"5","author":"Tejura","year":"2018","journal-title":"Open Forum Infect Dis"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e255390","DOI":"10.1136\/bcr-2023-255390","article-title":"Disseminated Mycobacterium abscessus with endocarditis","volume":"17","author":"Chue","year":"2024","journal-title":"BMJ Case Rep"},{"key":"B16","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1016\/j.pcad.2007.03.002","article-title":"A modern approach to tuberculous pericarditis","volume":"50","author":"Syed","year":"2007","journal-title":"Prog Cardiovasc Dis"},{"key":"B17","doi-asserted-by":"publisher","first-page":"005548","DOI":"10.12890\/2025_005548","article-title":"A case of polyserositis with pericarditis caused by Mycobacterium SPP","volume":"12","author":"Figueiredo","year":"2025","journal-title":"Eur J Case Rep Intern Med"},{"key":"B18","doi-asserted-by":"publisher","first-page":"003173","DOI":"10.12890\/2022_003173","article-title":"Refractory peritonitis and small bowel ileus: a case of encapsulating peritoneal sclerosis secondary to Mycobacterium abscessus peritonitis","volume":"9","author":"Rouhani","year":"2022","journal-title":"Eur J Case Rep Intern Med"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e1011318","DOI":"10.1371\/journal.ppat.1011318","article-title":"The cell envelope of Mycobacterium abscessus and its role in pathogenesis","volume":"19","author":"Parmar","year":"2023","journal-title":"PLoS Pathog"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1431","DOI":"10.1038\/s41564-022-01204-x","article-title":"Mycobacterium abscessus pathogenesis identified by phenogenomic analyses","volume":"7","author":"Boeck","year":"2022","journal-title":"Nat Microbiol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"449","DOI":"10.3389\/fcimb.2020.00449","article-title":"Comprehensive determination of Mycobacterium tuberculosis and nontuberculous mycobacteria from targeted capture sequencing","volume":"10","author":"He","year":"2020","journal-title":"Front Cell Infect Microbiol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1093\/cid\/ciaa1125","article-title":"Treatment of nontuberculous mycobacterial pulmonary disease: an official ATS\/ERS\/ESCMID\/IDSA clinical practice guideline","volume":"71","author":"Daley","year":"2020","journal-title":"Clin Infect Dis"},{"key":"B23","doi-asserted-by":"publisher","first-page":"732","DOI":"10.1016\/j.cmi.2023.10.001","article-title":"Alternative therapies against Mycobacterium abscessus infections","volume":"30","author":"Palucci","year":"2023","journal-title":"Clin Microbiol Infect"},{"key":"B24","doi-asserted-by":"publisher","first-page":"e0032225","DOI":"10.1128\/mbio.00322-25","article-title":"Cell envelope polysaccharide modifications alter the surface properties and interactions of Mycobacterium abscessus with innate immune cells in a morphotype-dependent manner","volume":"16","author":"Lian","year":"2025","journal-title":"mBio"},{"key":"B25","doi-asserted-by":"publisher","first-page":"333","DOI":"10.7326\/M22-3306","article-title":"Mycobacterium abscessus cluster in cardiac surgery patients potentially attributable to a commercial water purification system","volume":"176","author":"Klompas","year":"2023","journal-title":"Ann Intern Med"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1897","DOI":"10.1007\/s15010-026-02808-9","article-title":"Rapidly growing mycobacteria in cardiac implantable electronic device infections: a case series and literature review","volume":"54","author":"Delgado Moreno","year":"2026","journal-title":"Infection"},{"key":"B27","doi-asserted-by":"publisher","first-page":"100934","DOI":"10.1016\/j.lanmic.2024.06.001","article-title":"Endocarditis associated with contamination of cardiovascular bioprostheses with Mycobacterium chelonae: a collaborative microbiological study","volume":"5","author":"Kikhney","year":"2024","journal-title":"Lancet Microbe"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.1016\/j.ajt.2023.04.009","article-title":"Epidemiology, management, and clinical outcomes of extrapulmonary Mycobacterium abscessus complex infections in heart transplant and ventricular assist device recipients","volume":"23","author":"Friedland","year":"2023","journal-title":"Am J Transplant"},{"key":"B29","doi-asserted-by":"publisher","first-page":"e70592","DOI":"10.1002\/rcr2.70592","article-title":"Microscopic polyangiitis after pulmonary nontuberculous mycobacterial disease: a case report and literature review","volume":"14","author":"Takahashi","year":"2026","journal-title":"Respirol Case Rep"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1910932\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T10:17:23Z","timestamp":1788949043000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1910932\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,9]]},"references-count":29,"alternative-id":["10.3389\/fmed.2026.1910932"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1910932","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,9]]},"article-number":"1910932"}}