# A Case of Delayed Refractory Mycobacterium mageritense Abdominal Wall Abscess in a Kidney Transplant Recipient

## TL;DR

A kidney transplant patient developed a rare bacterial abscess that was hard to treat and required careful management of both infection and immune suppression.

## Contribution

This case highlights the challenges of treating Mycobacterium mageritense infections in transplant recipients and the need for tailored immunosuppressive adjustments.

## Key findings

- M. mageritense caused a refractory abdominal wall abscess in a kidney transplant recipient.
- Adjusting immunosuppression and using long-term antibiotics helped control the infection.
- Prophylactic levofloxacin was effective in preventing relapse after discharge.

## Abstract

Mycobacterium mageritense
(
M. mageritense
), a rare non‐tuberculous mycobacterium (NTM), can cause infections in immunocompromised patients, including kidney transplant recipients. We present a case of an abdominal wall abscess caused by
M. mageritense
following a living donor kidney transplant.

A 58‐year‐old woman, post‐ABO‐incompatible kidney transplant, developed an abscess at the site of a removed peritoneal dialysis catheter. Initial antibiotics were ineffective, and pus cultures identified
M. mageritense
. Surgical drainage and levofloxacin‐linezolid therapy controlled the infection temporarily. Despite clinical improvement, the abscess recurred 30 days post‐discharge, which required repeated antibiotic use and adjustments to immunosuppression. Reducing mycophenolate mofetil while maintaining tacrolimus stabilized the infection, and prophylactic levofloxacin was continued post‐discharge to prevent relapse.

Effective infection control requires careful immunosuppressive adjustment and long‐term antibiotic use to balance graft preservation with infection risk.