Mycobacterium Chelonae Infections Involving the Head and Neck

Abstract

Mycobacterium chelonae should be considered in cases of abscesses that persist despite broad-spectrum intravenous antibiotics, and in cases of maxillary sinusitis with bony involvement that do not respond to traditional treatment methods.

Central skull base osteomyelitis

“…Though considered a nearly ubiquitous organism, it historically has not been identified as an infectious entity. However, the rise of acquired immune deficiency syndrome and the more widespread use of immunosuppressive agents for malignancy have facilitated the recognition of this organism since the 1980s . Fungal pathogens are rare, present as the sole organisms in five patients and mixed with bacteria in two patients, with Aspergillus spp being implicated in three cases.…”

“…Technetium 99m CT is capable of confirming bony involvement within 24 hours of disease onset, and has been suggested as the most sensitive early test for MOE. The test has a reported sensitivity for osteomyelitis approaching 100%, as the radiotracer accumulates in sites of osteoblastic activity . This modality has largely replaced indium−111 tagged white blood cell scan, as technetium studies can be interpreted in a matter of hours rather than days and yields a higher quality image .…”

“…This accumulation, however, is relatively nonspecific and can remain positive for an extended period of time. Gallium‐67 scintigraphy has a reported 93% specificity for osteomyelitis, and reveals active infection by binding to granulocytes and dividing cells . It therefore may be more useful for disease progression, as enhanced uptake of gallium in active disease will resolve more rapidly than technetium 99m CT .…”

Prevalence and diversity of Chlamydiales and other amoeba-resisting bacteria in domestic drinking water systems

“…In addition, various nontuberculous mycobacteria have been recovered using amoebal co-culture and amoebal enrichment, including several human pathogens, such as M. mucogenicum [55] and M. chelonae, which have mainly been shown to cause respiratory [56], [57] and soft tissue [58] infection. M. gordonae, which is also sometimes considered pathogenic [59], [60], [61], [62], [63], has been previously isolated from drinking water [43], [64] and was isolated in our study from water and biofilm samples.…”

Atypical Mycobacterium Detection in Refractory Chronic Rhinosinusitis

“…To our knowledge, this is the largest series describing an experience with AM-associated CRS. While AM-associated pathogenicity involving pulmonary, cutaneous, and soft tissue in the setting of trauma, nosocomial infection, and immunosuppression has well been described in literature, 1,2 there remains a paucity of information regarding AM-associated CRS, with available published reports presenting 1 to 4 cases 3,4 and 1 abstract describing 21 patients. 5 To be sure, this is an uncommon condition; in our experience, we have identified only 37 AM-associated CRS patients out of more than 2000 new patient visits during this 6-year timeline.…”