Cutaneous manifestations of Mycobacterium gordonae infection described for the first time in Italy: a case report

Abstract

IntroductionMycobacterium gordonae is one of the least pathogenic of the mycobacteria. This pathogen may produce caseating or non-caseating granulomas, and skin lesions showing acute or chronic inflammation with scattered histiocytes and giant cells have been seen. The mortality rate is less than 0.1%. Mycobacterium gordonae may be a marker of severe immunosuppression in patients infected with human immunodeficiency virus.Case presentationWe report a case of Mycobacterium gordonae infection in an 86-year-old woman and discuss the problems inherent to the identification and treatment of this emerging pathogen. Mycobacterium gordonae strain we isolated was resistant to trimethoprim-sulfamethoxazole but sensitive to ciprofloxacin, and long term administration (six months) induced complete healing of the cutaneous abscesses.ConclusionAdvanced laboratory diagnostic techniques have improved the isolation and identification of nontuberculous mycobacteria. The diagnosis requires a high index of clinical suspicion, as detection by conventional methods is difficult. To our knowledge, this patient is the first documented case of cutaneous infection from this pathogen in Italy.

Molecular Isolation of Pathogenic Non-tuberculous Mycobacteria in Free Ranging Migratory Wildebeests (<i>Connochaetes taurinus</i>) and Cattle of Masai Mara, Kenya

“…The organism is ubiquitous and it is most commonly isolated from soil and water (Caterina et al, 2009). Clinically significant disease caused by M. gordonae has been reported (Weinberger et al, 1992).…”

Mycobacterium gordonae in Patient with Facial Ulcers, Nosebleeds, and Positive T-SPOT.TB Test, China

“…Nontuberculous mycobacteria are increasingly more involved in causing human infections. Mycobacterium gordonae , a type of slow-growing nontuberculous mycobacterium, is generally regarded as a weak pathogen, although it has caused some disease in humans ( 1 – 3 ). We describe a case of M. gordonae infection in the facial skin, nasal mucosa, and paranasal sinus of an immunocompetent patient in China.…”

“…The most common lesions caused by M. gordonae are nodules that slowly enlarge and become ulcerated over several months. Lesions usually are located on the face, at distal extremities, or at sites of previous trauma ( 1 , 5 – 8 ). In this case, the infection caused lesions throughout the facial skin, nasal mucosa, and paranasal sinus, probably because the delay in accurate diagnosis allowed for wide dissemination of the pathogen.…”

Isolation and Genomic Analysis of an Intracellular Mycobacterium gordonae from a Free-Living Acanthamoeba sp. in a Hospital Environment in Lima, Peru

“… Mycobacterium gordonae is an opportunistic nontuberculous mycobacterium (NTM) ubiquitous in water systems ( 1 – 4 ), where it shares a habitat with free-living amoebae (FLA) ( 5 – 8 ). Infections are associated with immunocompromised patients but may occur in immunocompetent hosts ( 9 – 15 ). Exposure to water networks and bodies poses a potential risk for disease ( 16 , 17 ).…”