Disseminated<i>Mycobacterium avium</i>Complex With Cutaneous Lesions

Kollipara, Ramya; Richards, Kristen; Tschen, Jaime A.; Campbell, Lauren S.; Tyring, Stephen K.; Mays, Steven R.

doi:10.1177/1203475415626088

Cited by 10 publications

(8 citation statements)

References 17 publications

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“…Lesions in multiple stages of development may co-exist. Morphological features are usually non-specific and skin biopsy is the gold standard for diagnosis [ 16 ]. Data regarding cutaneous disease in M. Colombiense infection is scarce and only one case has been reported before.…”

Section: Discussionmentioning

confidence: 99%

Disseminated nontuberculous mycobacterial infection with cryptic immunodeficiency mimicking malignancy: a case report

et al. 2022

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Background Nontuberculous mycobacteria (NTM) usually invades vulnerable hosts. Disseminated NTM (dNTM) infection can affect nearly all organs and be easily misdiagnosed as metastatic carcinoma or other systemic diseases, especially in seemingly immunocompetent hosts. Identification of underlying immunodeficiency is critical for the diagnosis and treatment of dNTM. Adult-onset immunodeficiency (AOID) with anti-IFN-γ autoantibodies has recently been recognized as a crucial but frequently neglected risk factor for dNTM infection. Frequent relapses of infection are common in AOID patients despite appropriate anti-infective treatment and B-cell-depleting therapy has shown some promising results. Herein, we report a case of dNTM infection mimicking malignancy in an AOID patient who was successfully treated with rituximab. Case presentation A middle-aged male presented with fever, productive cough, multifocal skin abscesses and multiple osteolytic lesions with pathological fractures. Chest CT revealed consolidation of the lingula while bronchoscopy showed a mass completely blocking the airway opening of the inferior lingual segment. Metagenomic next-generation sequencing and mycobacterial culture of skin pus and bronchoalveolar lavage fluid reported Mycobacterium Colombiense, confirming the diagnosis of dNTM infection. However, anti-NTM antibiotics alone failed to prevent disease relapse and progression. Further evaluation indicated undetectable serum IFN-γ concentration and high-titer autoantibodies against IFN-γ, suggesting that AOID was the underlying reason for dNTM. Rituximab was added to treatment and successfully controlled the infection without relapse at one-year follow-up. Conclusion We reported a rare case of disseminated Mycobacterium Colombiense infection manifested with pulmonary mass, pathological fracture and dermapostasis in a host with AOID. Our case demonstrated that AOID should be screened when patients get the episode of disseminated NTM infection particularly when other risk factors are excluded. Besides prolonged anti-NTM therapy, AOID-associated NTM infection should be treated with B-cell-depleting therapy to prevent recurrence.

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Section: Discussionmentioning

confidence: 99%

Disseminated nontuberculous mycobacterial infection with cryptic immunodeficiency mimicking malignancy: a case report

et al. 2022

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“…While both mycobacterial cultures were negative in this case, the authors feel confident in the diagnosis of MAC based on histopathology, PCR, nucleic acid sequencing and clinical response to treatment. Culture of MAC in both human and veterinary medicine can be difficult and challenging due to the sensitive nature of the organism combined with the time‐consuming and laborious technique required of laboratories 11…”

Section: Discussionmentioning

confidence: 99%

Cutaneous manifestation of Mycobacterium avium complex infection in an Australian shepherd dog

Ramos

Woodward

Wakamatsu

et al. 2019

Vet Record Case Reports

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A three-year-old male neutered Australian shepherd dog presented with a one-week history of diffuse ulcerative cutaneous nodules. On physical examination the dog had generalised lymphadenomegaly with multiple well-circumscribed subcutaneous to dermal nodules with central haemorrhagic ulceration affecting the face, dorsum, dorsal cervical area and abdomen. Histopathological findings revealed severe suppurative and pyogranulomatous dermatitis and panniculitis with acid-fast pleomorphic bacterium present. Mycobacterial culture of tissue was negative. Repeated PCR assays on formalin-fixed tissue followed by nucleic acid sequencing confirmed the presence of Mycobacterium avium complex. Treatment was initiated with clarithromycin (10.9 mg/kg orally every 12 hours) and rifampin (13.2 mg/kg orally every 24 hours) and resulted in clinical resolution of the lesions within two weeks. Treatment was continued for six months and then discontinued. Seventeen months following treatment discontinuation, the dog was clinically and systemically well with no relapse noted.

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“…Nevertheless, disseminated MAC with skin involvement continues to be a problem in advanced immunosuppression, and recurrent MAC infections in patients on ART have been reported (153). MAC-associated skin lesions can be polymorphous, presenting most commonly as subcutaneous nodules, but also as scaly plaques, crusted ulcers, ecthyma-like lesions, and draining sinuses (154)(155)(156). Localized or primary cutaneous infections have also been reported as sporotrichoid eruptions and abscesses (157)(158)(159).…”

Section: Atypical Mycobacteria-mentioning

confidence: 99%

HIV-Related Skin Disease in the Era of Antiretroviral Therapy: Recognition and Management

et al. 2019

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Anti-retroviral therapy (ART) has revolutionized the treatment and prognosis of people living with HIV (PLHIV). With increased survival and improved overall health, PLHIV are experiencing dermatologic issues both specific to HIV and common to the general population. In this new era of ART, it is crucial for dermatologists to have a strong understanding of the broad range of cutaneous disease and treatment options in this unique population. In this review, we outline the most common skin diseases in PLHIV, including HIV-associated malignancies, inflammatory conditions, and infections, and focus on the role of ART in altering epidemiology, clinical features, diagnosis, and treatment of cutaneous conditions.

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DisseminatedMycobacterium aviumComplex With Cutaneous Lesions

Cited by 10 publications

References 17 publications

Disseminated nontuberculous mycobacterial infection with cryptic immunodeficiency mimicking malignancy: a case report

Disseminated nontuberculous mycobacterial infection with cryptic immunodeficiency mimicking malignancy: a case report

Cutaneous manifestation of Mycobacterium avium complex infection in an Australian shepherd dog

HIV-Related Skin Disease in the Era of Antiretroviral Therapy: Recognition and Management

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