Diagnostic and therapeutic considerations for cutaneous Mycobacterium haemophilum infections

McBride, M. E.

doi:10.1001/archderm.127.2.276

Cited by 13 publications

(8 citation statements)

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“…Skin lesions in immunocompetent adults due to M. haemophilum infection are rare and the result of injury. Two cases have been reported (99,128): a 61-yearold male who sustained several lacerations to the forearm when he was thrown against coral while surfing and a 65-yearold female who developed subcutaneous skin nodules after coronary artery bypass surgery. 3, 123, 141, 147).…”

Section: Immunocompetent Patients Adult Infectionsmentioning

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: Immunocompetent Patients Adult Infectionsmentioning

confidence: 99%

Clinical Manifestations, Diagnosis, and Treatment of Mycobacterium haemophilum Infections

et al. 2011

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“…A marked second cluster of cases was seen among otherwise healthy females after age 50, but no cases of male patients were seen in this age range. Furthermore, a recent report describes the development of a localized skin lesion, culturally proven to be associated with M. haemophilum, in a nonimmunosuppressed 65-year-old woman (119 70.6% between the two species clusters and a mean matching score of only 69.6% to the type strain of M. szulgai (220).…”

Section: Kansasiimentioning

confidence: 99%

Agents of newly recognized or infrequently encountered mycobacterial diseases

1992

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This paper reviews recent information on the systematics and clinical significance of potentially pathogenic environmental mycobacteria. A short history of these mycobacteria is given. Information on species for which clinical and systematic aspects have already been well documented, i.e., Mycobacterium kansasii, M. marinum, M. scrofulaceum, M. simiae, M. szulgai, M. ulcerans, M. xenopi, and members of the M. fortuitum complex, is updated. Although the M. avium complex was extensively reviewed in earlier literature, major new systematic and clinical information is presented in some detail. Species that have received very limited prior coverage, i.e., M. asiaticum, M. haemophilum, M. malmoense, and M. shimoidei, are the main subjects of this review and are discussed in detail. The rare infections attributed to species that are normally considered nonpathogenic, i.e., M. gastri, M. gordonae, the M. terrae complex, and most of the rapidly growing mycobacteria outside of the M. fortuitum complex, are critically reviewed. Finally, suggestions are offered for practical measures that can minimize the risk of failing to isolate or misidentifying some of the more obscure potentially pathogenic environmental mycobacteria that are only infrequently recognized.

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“…The most detailed descriptions of test procedures used were noted in six papers reporting the results of 18 isolates. A variety of agar methods were described in five papers (3,7,11,13,14), and a broth microdilution method was used for the sixth paper (20).…”

Section: Discussionmentioning

confidence: 99%

Activities of antimicrobial agents against clinical isolates of Mycobacterium haemophilum

Bernard

Edwards

Kiehn

et al. 1993

Antimicrob Agents Chemother

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Mycobacterium haemophilum, first described in 1978, can cause severe infections of skin, respiratory tract, bone, and other organs of immunocompromised patients. There is no standardized antimicrobial susceptibility test, and for the 27 reported cases, a variety of test methods have been used. This paper reports the in vitro test results for 17 isolates of M. haemophilum recovered from 12 patients in the New York City area. MICs of 16 antimicrobial agents were determined in microtiter trays containing Middlebrook 7H9 broth plus 60 ,uM hemin, inoculated with 106 CFU of the organism per ml and incubated at 30'C for 10 days. Ethambutol, ethionamide, tetracycline, cefoxitin, and trimethoprim-sulfamethoxazole were inactive against initial isolates from the 12 patients. Isoniazid was weakly active with a MIC for 50%o of strains tested (MIC50) of 8 ,ig/ml and a MIC90 of >32 ,ug/ml. Three quinolones, ciprofloxacin, ofloxacin, and sparfloxacin, were moderately active with MIC50s of 2 to 4 ,ug/ml and MIC90s of 4 to 8 ig/ml. Amikacin and clofazamine were active with MIC90s of 4 and 2 ,Ig/ml, respectively. Clarithromycin was the most active macrolide with a MIC90 of .0.25 pg/mI. The MIC90 of azithromycin was 8 pg/ml, and the MIC90 of erythromycin was 4 ,ug/ml. The rifamycins were active with a MIC90 of 1 ,ug/ml for rifampin and one of <0.03 pg/ml for rifabutin. For a second isolate from the skin of one patient and an isolate from an autopsy culture of the spleen of a second patient, MICs of rifampin and rifabutin were > 16 p,g/ml, whereas initial isolates were inactivated by low concentrations of the rifamycins. Both patients had been treated for several months with several antimicrobial agents, including a rifamycin.

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Diagnostic and therapeutic considerations for cutaneous Mycobacterium haemophilum infections

Cited by 13 publications

References 0 publications

Clinical Manifestations, Diagnosis, and Treatment of Mycobacterium haemophilum Infections

Clinical Manifestations, Diagnosis, and Treatment of Mycobacterium haemophilum Infections

Agents of newly recognized or infrequently encountered mycobacterial diseases

Activities of antimicrobial agents against clinical isolates of Mycobacterium haemophilum

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