An immunocompetent patient developed Mycobacterium abscessus meningitis after receiving intrathecal stem cell injections at a commercial clinic in Baja California, Mexico, highlighting severe central nervous system risks associated with medical tourism and unregulated cellular treatments.
A case documented by researchers detailed the clinical course of an adult woman who developed a serious central nervous system infection following stem cell procedures abroad. The report outlines the diagnostic challenges, clinical presentation, and subsequent medical management required to address a rapidly growing nontuberculous mycobacterium.
Medical Tourism and the Search for Multiple Sclerosis Treatment in Baja California
The patient, an immunocompetent woman in her 30s, had been diagnosed with multiple sclerosis three years prior to her initial encounter, meeting 2017 McDonald criteria based on episodic numbness and multifocal brain and spinal demyelinating lesions identified by magnetic resonance imaging. She had never received disease-modifying therapies or other immunosuppressive medications, and her baseline neurological examination was unremarkable.
In October 2022, she traveled to a commercial clinic in Baja California, Mexico, after researching stem cell treatments on the facility’s website. During a four-day visit, she underwent two lumbar punctures for the intrathecal injection of donor umbilical cord stem cells programmed to treat her condition.
Headache, Blood Patches, and the Onset of Persistent Fevers
The day after her second procedure, the patient sought care at an emergency department in the United States complaining of a positional headache. Clinicians treated her with an epidural blood patch for a presumed cerebrospinal fluid leak caused by the lumbar punctures. Although she reported nocturnal fevers, her vital signs, neurological examination, complete blood counts, and head computed tomography scan were unremarkable at that time.
She was discharged after her headache improved, but she subsequently required two additional blood patches in outpatient settings for recurrent headaches. Persistent fevers ultimately prompted her admission to an outside hospital five days after her third blood patch.
At admission, she was febrile (101.3°F), but vital signs and complete blood counts were otherwise within reference ranges and HIV serology results were negative.
University of Colorado School of Medicine and National Jewish Health researchers
Cerebrospinal fluid sampling at that hospital revealed 74 nucleated cells per microliter—predominantly neutrophils—along with elevated protein and depressed glucose levels. Bacterial cultures showed no initial growth, and viral polymerase chain reaction tests for herpes simplex virus and enterovirus were negative. Physicians initiated empiric treatment with vancomycin and cefepime, transitioning the regimen due to an allergic rash and ultimately completing a course of imipenem that temporarily resolved her fevers and headaches.
Relapse and Identification of Mycobacterium abscessus Meningitis
Days after finishing antibiotics, the patient experienced a severe recurrence of headaches and fevers, leading to her admission to a specialized medical institution. A repeat cerebrospinal fluid analysis demonstrated 104 nucleated cells per microliter, with elevated protein and oligoclonal bands consistent with her underlying multiple sclerosis but also signaling potential central nervous system infection reported by the study authors. Brain and spine magnetic resonance imaging showed no active demyelination or structural infection.
Medical teams initiated empiric coverage with vancomycin and ceftriaxone, which brought partial symptom relief. After seven days of incubation, her cerebrospinal fluid cultures turned positive, isolating Mycobacterium abscessus, a rapidly growing organism known to cause difficult-to-treat infections.
Mycobacterium abscessus is a nontuberculous mycobacterium commonly found in soil and water. While pulmonary and soft-tissue infections typically stem from contaminated water or inadequate sterilization of medical reagents, central nervous system infections remain rare and challenging, often requiring prolonged multidrug regimens or surgical intervention.