Broad Spectrum of Dermatologic Manifestations Caused by Mycobacterium haemophilum Infection

Geisler, William M.; Harrington, Robert D.; Wallis, Carolyn K.; Harnisch, James P.; Liles, W. Conrad

doi:10.1001/archderm.138.2.229

Cited by 25 publications

(19 citation statements)

References 4 publications

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“…M. haemophilum infections have been reported, especially in patients with lymphoma or HIV and in organ transplant recipients (19,66,81,84,112,153). The clinical spectrum of cutaneous infections caused by M. haemophilum appears to be broad (19,30), varying from localized disease to systemic disease with cutaneous dissemination (49). Multiple skin lesions tend to occur and can present as erythematous papules, plaques, nodules, necrotic abscesses, or chronic ulcers.…”

Section: Cutaneous Manifestationsmentioning

confidence: 99%

Clinical Manifestations, Diagnosis, and Treatment of Mycobacterium haemophilum Infections

et al. 2011

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SUMMARY Mycobacterium haemophilum is a slowly growing acid-fast bacillus (AFB) belonging to the group of nontuberculous mycobacteria (NTM) frequently found in environmental habitats, which can colonize and occasionally infect humans and animals. Several findings suggest that water reservoirs are a likely source of M. haemophilum infections. M. haemophilum causes mainly ulcerating skin infections and arthritis in persons who are severely immunocompromised. Disseminated and pulmonary infections occasionally occur. The second at-risk group is otherwise healthy children, who typically develop cervical and perihilar lymphadenitis. A full diagnostic regimen for the optimal detection of M. haemophilum includes acid-fast staining, culturing at two temperatures with iron-supplemented media, and molecular detection. The most preferable molecular assay is a real-time PCR targeting an M. haemophilum -specific internal transcribed spacer (ITS), but another approach is the application of a generic PCR for a mycobacterium-specific fragment with subsequent sequencing to identify M. haemophilum . No standard treatment guidelines are available, but published literature agrees that immunocompromised patients should be treated with multiple antibiotics, tailored to the disease presentation and underlying degree of immune suppression. The outcome of M. haemophilum cervicofacial lymphadenitis in immunocompetent patients favors surgical intervention rather than antibiotic treatment.

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Section: Cutaneous Manifestationsmentioning

confidence: 99%

Clinical Manifestations, Diagnosis, and Treatment of Mycobacterium haemophilum Infections

et al. 2011

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“…M. haemophilum has a predilection for the skin due to its optimal growth temperature of 30°C; however, disseminated infections have been reported [1–3]. Like all NTM, M. haemophilum is an environmental pathogen with some suggestion of water as a reservoir for the organisms [2].…”

Section: Discussionmentioning

confidence: 99%

“…M. haemophilum cutaneous infections manifest as painless erythematous papules, plaques, and nodules that may coalesce into annular formations and can progress to necrotic abscesses and chronic ulcers. Early lesions are typically painless, though they become painful if they progress to abscesses or ulcers [2, 3]. There is a broad differential for the variable skin manifestations including various NTM species, deep fungal infections, cutaneous lymphoma, and the varied spectrum of cutaneous leprosy manifestations.…”

Section: Discussionmentioning

confidence: 99%

“…The growth of M. haemophilum requires incubation at 30°C and addition of iron or hemin to the culture medium [1, 2]. Treatment for M. haemophilum typically consists of combination of clarithromycin, ciprofloxacin, and a rifamycin for typically 6 weeks to 6 months and up to 2 years in immunosuppressed patients [2, 3]. The specific regimen may have to be tailored and closely monitored due to the significant potential for drug interactions with immunosuppressive regimens.…”

Section: Discussionmentioning

confidence: 99%

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Mycobacterium haemophilumMasquerading as Leprosy in a Renal Transplant Patient

Copeland

Arora

Ferguson

2013

Case Reports in Dermatological Medicine

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Opportunistic infections following immunosuppression in solid organ transplant (SOT) patients are common complications with the skin being a common sight of infection. Nontuberculous mycobacteria (NTM) are rare but potential causes of skin infection in SOT patients. We present a case of an adult male immunosuppressed following renal transplantation who presented with an asymptomatic rash for several months. The patient's skin eruption consisted of erythematous papules and plaques coalescing into an annular formation. After failure of the initial empiric therapy, a punch biopsy was performed that demonstrated nerve involvement suspicious for Mycobacterium leprae. However, culture of the biopsy specimen grew acid-fast bacilli that were subsequently identified as M. haemophilum. His rash improved after a prolonged course of clarithromycin and ciprofloxacin. Both organisms are potential causes of opportunistic skin infections and can be difficult to distinguish with similar predilection for skin and other biochemical and genetic similarities. Ultimately they can be distinguished with culture as M. haemophilum will grow in culture and M. leprae will not. This case was unique due to nerve involvement on biopsy which is classically seen on biopsies of leprosy.

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“…Immunosuppressed patients may demonstrate nodules and ulceration as seen in our patient. Swelling, cyst formation, scaling plaques, cellulitis, and panniculitis also occur (1–5,13). Cutaneous lesions favor the extremities, particularly overlying joints, possibly due to lower temperatures at acral sites (13).…”

Section: Discussionmentioning

confidence: 99%

Mycobacterium haemophilum in an Immunosuppressed Child

Campbell¹,

Maroon²,

Pride³

et al. 2006

Pediatric Dermatology

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Mycobacterium haemophilum is an emerging cutaneous and systemic pathogen in immunosuppressed adults. Reports in the pediatric literature prior to 2004, limited to immunocompetent children with lymphadenitis, offer a different clinical presentation from that of the immunosuppressed adult. We report an instance of this atypical mycobacterial infection occurring in an immunosuppressed boy with clinical findings similar to those described in immunosuppressed adults.

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Broad Spectrum of Dermatologic Manifestations Caused by Mycobacterium haemophilum Infection

Cited by 25 publications

References 4 publications

Clinical Manifestations, Diagnosis, and Treatment of Mycobacterium haemophilum Infections

Clinical Manifestations, Diagnosis, and Treatment of Mycobacterium haemophilum Infections

Mycobacterium haemophilumMasquerading as Leprosy in a Renal Transplant Patient

Mycobacterium haemophilum in an Immunosuppressed Child

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