Clinical Characteristics and Treatment Outcomes for Patients Infected withMycobacterium haemophilum

Abstract

Mycobacterium haemophilum is a nontuberculous mycobacterium that can infect immunocompromised patients. Because of special conditions required for its culture, this bacterium is rarely reported and there are scarce data for long-term outcomes. We conducted a retrospective study at Siriraj Hospital, Bangkok, Thailand, during January 2012–September 2017. We studied 21 patients for which HIV infection was the most common concurrent condition. The most common organ involvement was skin and soft tissue (60%). Combination therapy with macrolides and fluoroquinolones resulted in a 60% cure rate for cutaneous infection; adding rifampin as a third drug for more severe cases resulted in modest (66%) cure rate. Efficacy of medical therapy in cutaneous, musculoskeletal, and ocular diseases was 80%, 50%, and 50%, respectively. All patients with central nervous system involvement showed treatment failures. Infections with M. haemophilum in HIV-infected patients were more likely to have central nervous system involvement and tended to have disseminated infections and less favorable outcomes.

Meningomyeloencephalitis secondary to Mycobacterium haemophilum infection in AIDS

“…The autopsy was CNS-restricted and so unfortunately identification of an extra-CNS origin could not be ascertained. In immunocompromised patients, M. haemophilum most commonly infects the skin, while pulmonary, bone, and joint infections are less frequent systems of involvement [6,16]. Aside from concerns of an aspiration pneumonia later in the patient's course, there were no pulmonary, dermatologic, or joint complaints documented during his clinical course.…”

Mycobacterium haemophilum scleritis: two case reports and review of literature

“…Diagnosis of M. haemophilum ocular infection is challenging. The majority of patients with this infection had underlying immunocompromised conditions, including diabetes mellitus, use of immunosuppressive agents, and young age [5][6][7][8][9]. However, one of our 2 cases was an immunocompetent host.…”

Mycobacterium haemophilum skin and soft tissue infection in a kidney transplant recipient: A case report and summary of the literature

“…We with at least two-drug combination therapy were more likely to be cured. 10,11 Drug-drug interactions are one of the caveats challenging clini- In a retrospective study linking healthcare databases across Canada, there was no significant difference observed in allograft dysfunction between kidney transplant recipients who received clarithromycin and azithromycin. 13 In our case, we informed transplant nephrologists of these potential effects and levels of immunosuppressants…”

“…The patient described by Sagi et al later developed tenosynovitis of the tendons underneath the infected tissue and local abscess formation. Nookeu et al reported a case of cutaneous M haemophilum infection with tenosynovitis of the right finger in a patient with systemic lupus erythematosus 2 …”

“…The organism was initially identified in 1978 from the ulcers of a patient with Hodgkin's disease who was receiving immunosuppressive therapy 1 . Similarly to Mycobacterium leprae, M haemophilum expresses phenolic glycolipid antigens and contains docosanoic acid 2 . Patients with M haemophilum infection typically present with localized cutaneous infection or cervicofacial lymphadenitis.…”