Cutaneous manifestations of infection by nontuberculous mycobacteria

Abstract

Cutaneous infections by nontuberculous mycobacteria (NTM) are not usual but their relative importance has changed during the last few years and still further changes are expected. This study comprised 13 patients from whom NTM were recovered from skin biopsy specimens, sinus exudates or cutaneous abscesses. All samples were processed according to standard methods, and the isolates were identified by biochemical testing. Skin biopsy specimens, when available, were processed for histopathological study. The clinical records of the patients were reviewed, and the relevant clinical, microbiological and epidemiological data collected. The clinical manifestations were noted to be relatively nonspecific and consisted of draining sinuses, abscesses, ulcers and nodules with multicentric or sporotrichoid patterns. Tissue culture isolated Mycobacterium fortuitum complex in nine patients, M. avium in three, and M. marinum in one. In the nine patients studied by histopathology, various patterns were observed. These included dermo-hypodermal abscesses, suppurative granulomas, tuberculoid granulomas and granulomas with a perifollicular distribution. Cutaneous lesions can thus be the first and the only sign of NTM disease, and culture still remains the definitive diagnostic procedure.

Osteomyelitis due to Mycobacterium fortuitum after Open Tibial fracture Case Report and a Summary of Diagnostic and Therapeutic Aspects

“…Although single oral drugs have been used successfully [20], most publishers prefer a combination of different antibiotics. In general, atypical mycobacteria are susceptible to certain quinolones [21,22], macrolids and beta-lactams [23]. In contrast, some isolates were resistant to a wide range of antimycobacterial drugs, including amikacin, cefoxitin [9] sulfonamides and aminoglycosides [15,24], Consequently, susceptibility testing of the isolated strain is a prerequisite for successful antibiotic therapy.…”

Neutrophilic Panniculitis: Algorithmic Approach to a Heterogeneous Group of Disorders

“…18 Epithelioid granulomas, with or without admixed neutrophils, are strongly indicative of infection when present in a background of neutrophilic panniculitis (Figure 3, D). 19 Lastly, demonstration of microorganisms on hematoxylin-eosin, tissue Gram, Grocott methenamine silver, or Fite stains, or positive microbial cultures would confirm the diagnosis.…”

Localized Cutaneous Infections in Immunocompetent Individuals Due to Rapidly Growing Mycobacteria

“…The majority of solitary lesions occur on the lower extremities, but the upper extremities, trunk, and rarely head and neck may also be involved. 9,10 Additionally, there are a number of reports of cutaneous M chelonae infections in immunocompetent hosts due to subcutaneous inoculation with contaminated tattoo ink, 8,11,12 after acupuncture, 13,14 and after mesotherapy. 15 Mycobacterium abscessus, M chelonae, Mycobacterium conceptionense, and M fortuitum have all been isolated in postoperative infections after plastic surgery procedures.…”

“…In immunocompetent hosts, complete surgical excision, if possible, may be curative, 17 though cure is most reliably achieved with a combination of medical and surgical therapy. 9,10,16 This is in contrast to disseminated cutaneous infection in immunocompromised hosts, for whom prognosis can be quite poor even with adequate treatment. 30 …”