{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:13:21Z","timestamp":1760058801098,"version":"build-2065373602"},"reference-count":14,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Mycobacterium chimaera infections are becoming increasingly frequent in patients with a history of cardiac surgery. We herein report a case of a patient admitted to the Nephrology Unit of Padua University Hospital with deteriorating kidney function, pancytopenia, hypercalcemia, and respiratory symptoms that emerged seven years after they underwent heart surgery for prosthetic aortic valve replacement. A kidney biopsy revealed non-caseating necrotizing granulomatous interstitial nephritis, which was initially diagnosed as idiopathic granulomatous interstitial nephritis. The patient was treated with intravenous corticosteroids since no active infections, including mycobacterial infections, were detected. The negativity of the Mycobacterium molecular test following the kidney biopsy delayed the diagnosis of a Mycobacterium chimaera disseminated infection with endocarditis, myositis, cerebral, and kidney involvement, as blood cultures were available only after six weeks. The patient was started on antimicrobial therapy with azithromycin, moxifloxacin, rifampicin, and ethambutol while prednisone was tapered down, leading to an improvement in kidney function, blood count, and blood calcium level. Our case suggests that a Mycobacterium chimaera infection should be considered for patients with a history of cardiac surgery and granulomatous interstitial nephritis even in the absence of mycobacteria in a kidney biopsy.<\/jats:p>","DOI":"10.3390\/microorganisms13051019","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T05:17:12Z","timestamp":1745903832000},"page":"1019","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Case of Granulomatous Interstitial Nephritis Associated with Mycobacterium chimaera Disseminated Infection"],"prefix":"10.3390","volume":"13","author":[{"given":"Martina","family":"Cacciapuoti","sequence":"first","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, University Hospital of Padova, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0263-0703","authenticated-orcid":false,"given":"Maria","family":"Mazzitelli","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Disease Unit, University Hospital of Padova, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Naso","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, University Hospital of Padova, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Loreta","family":"De Giorgi","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, University Hospital of Padova, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Samassa","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, University Hospital of Padova, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Di Vico","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, University Hospital of Padova, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serena","family":"Marinello","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Disease Unit, University Hospital of Padova, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia Federica","family":"Stefanelli","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, University Hospital of Padova, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Cal\u00f2","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, University Hospital of Padova, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2869-2945","authenticated-orcid":false,"given":"Annamaria","family":"Cattelan","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Disease Unit, University Hospital of Padova, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1167-2764","authenticated-orcid":false,"given":"Federico","family":"Nalesso","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, University Hospital of Padova, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,29]]},"reference":[{"doi-asserted-by":"crossref","unstructured":"Bolcato, V., and Bassetti, M. (2024). The State-of-the-Art of Mycobacterium chimaera Infections and the Causal Link with Health Settings: A Systematic Review. Healthcare, 12.","key":"ref_1","DOI":"10.3390\/healthcare12171788"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2667","DOI":"10.1007\/s00414-021-02630-y","article-title":"Mycobacterium chimaera: A report of 2 new cases and literature review","volume":"135","author":"Natanti","year":"2021","journal-title":"Int. J. Leg. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1007\/s12630-016-0809-5","article-title":"Infection par mycobacterium via un g\u00e9n\u00e9rateur thermique utilis\u00e9 pendant la circulation extracorporelle chez une patiente immunosupprim\u00e9e suite \u00e0 un traitement de st\u00e9ro\u00efdes","volume":"64","author":"Cai","year":"2017","journal-title":"Can. J. Anesth."},{"doi-asserted-by":"crossref","unstructured":"Cocchio, S., and Nicoletti, M. (2024). Mycobacterium chimaera Infections in a Unit of Cardio Surgery: Study at a General Hospital in Padua, Italy. Microorganisms, 12.","key":"ref_4","DOI":"10.3390\/microorganisms12010029"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e00733","DOI":"10.1016\/j.idcr.2020.e00733","article-title":"Prosthetic valve endocarditis from Mycobacterium chimaera infection causing granulomatous interstitial nephritis","volume":"20","author":"Trautman","year":"2020","journal-title":"IDCases"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1769","DOI":"10.1128\/JCM.00435-13","article-title":"Prosthetic valve endocarditis and bloodstream infection due to Mycobacterium chimaera","volume":"51","author":"Achermann","year":"2013","journal-title":"J. Clin. Microbiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.jhin.2019.10.009","article-title":"International Society of Cardiovascular Infectious Diseases Guidelines for the Diagnosis, Treatment and Prevention of Disseminated Mycobacterium chimaera Infection Following Cardiac Surgery with Cardiopulmonary Bypass","volume":"104","author":"Hasse","year":"2020","journal-title":"J. Hosp. Infect."},{"key":"ref_8","first-page":"267","article-title":"Disseminated Mycobacterium chimaera infection after open heart surgery in an Italian woman: A case report and a review of the literature","volume":"25","author":"Chiesi","year":"2017","journal-title":"Infez. 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Mycobacteriol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2369","DOI":"10.1016\/j.jtcvs.2017.12.049","article-title":"Disseminated Mycobacterium chimaera infection associated with heater\u2013cooler units after aortic valve surgery without endocarditis","volume":"155","author":"Asadi","year":"2018","journal-title":"J. Thorac. Cardiovasc. Surg."}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/13\/5\/1019\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:23:44Z","timestamp":1760030624000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/13\/5\/1019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,29]]},"references-count":14,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["microorganisms13051019"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms13051019","relation":{},"ISSN":["2076-2607"],"issn-type":[{"type":"electronic","value":"2076-2607"}],"subject":[],"published":{"date-parts":[[2025,4,29]]}}}