<i>Mycobacterium haemophilum</i>: Emerging or Underdiagnosed in Brazil?

Sampaio, Jorge Luiz Mello; Alves, Venâncio Avancini Ferreira; Leão, Sylvia Cardoso; Magalhães, Vanda D.; Martino, Marinês Dalla Valle; Mendes, Caio; Misiara, Antonio Carlos de Oliveira; Miyashiro, Kozue; Pasternak, Jacyr; Rodrigues, E.J.; Rozenbaum, Ronaldo; Filho, Carlos Alberto Sant ́Anna; Teixeira, Sônia Regina Marques; Xavier, Adriano Cunha; Figueiredo, Margarida Garcia de; Leite, José Paulo Gagliardi

doi:10.3201/eid0811.020492

Cited by 15 publications

(13 citation statements)

References 8 publications

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“…Several publications suggest this species to be underdiagnosed, 25,30,31 which is confirmed by the results described here. Although increasing number of laboratories are applying specific culturing methods suitable for the recovery of M. haemophilum, some laboratories still do not.…”

Section: Discussionsupporting

confidence: 94%

Application of Real-time PCR to Recognize Atypical Mycobacteria in Archival Skin Biopsies

Coppenraet¹,

Smit²,

Templeton³

et al. 2007

Diagnostic Molecular Pathology

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Atypical mycobacterial skin infections are difficult to diagnose owing to their aspecific histopathologic presentations and to the presence of few bacteria. Therefore, these infections are often not recognized. Molecular detection of mycobacterial DNA has proven to be useful in clinical samples. The aim of this study was to investigate the incidence of mycobacterial involvement in skin biopsies showing granulomatous inflammation, using real-time polymerase chain reaction (PCR). Real-time PCR specific for the genus Mycobacterium and the species Mycobacterium avium and Mycobacterium haemophilum was performed on formalin-fixed/paraffin-embedded biopsies from patients with granulomatous inflammation of the skin, from the period 1984 to 2004. A control group was assembled from patients with proven basal cell carcinoma. Amplicons of all positive reactions were sequenced to confirm or identify the mycobacterial species. Of 30 patients, 13 (43%) were found to be positive for mycobacterial infection, of whom only 5 patients had been previously diagnosed with a mycobacterial disease. M. haemophilum was identified as the most common species (n=7). The other identified species were Mycobacterium malmoense, Mycobacterium gordonae, and Mycobacterium marinum. The results show that real-time PCR is useful in detecting mycobacterial infections in undiagnosed formalin-fixed/paraffin-embedded skin samples and that the application of molecular approaches would improve the diagnoses of mycobacterial skin infections.

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Section: Discussionsupporting

confidence: 94%

Application of Real-time PCR to Recognize Atypical Mycobacteria in Archival Skin Biopsies

Coppenraet¹,

Smit²,

Templeton³

et al. 2007

Diagnostic Molecular Pathology

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“…In such individuals, the classical clinical presentation has been that of multiple tender ulcerating cutaneous or subcutaneous nodular skin lesions, commonly on the extremities and often overlying joints [ 2 , 5 - 12 ]. Occasionally, lesions have been associated with cellulitis or complicated by abscess formation, fistula development, osteomyelitis, septic arthritis, or bacteremia [ 2 , 5 - 7 , 9 - 11 ]. Cases of pneumonia, pulmonary nodules, or sinusitis without skin lesions have also been described in both immunocompromised and immunocompetent individuals [ 2 , 3 , 5 - 7 , 9 - 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…Occasionally, lesions have been associated with cellulitis or complicated by abscess formation, fistula development, osteomyelitis, septic arthritis, or bacteremia [ 2 , 5 - 7 , 9 - 11 ]. Cases of pneumonia, pulmonary nodules, or sinusitis without skin lesions have also been described in both immunocompromised and immunocompetent individuals [ 2 , 3 , 5 - 7 , 9 - 12 ]. Several cases of localized lymphadenitis, particularly of the cervical, submandibular, and perihilar regions, have been reported in immunocompetent patients, especially children [ 1 - 3 ].…”

Section: Discussionmentioning

confidence: 99%

Mycobacterium haemophilum osteomyelitis: case report and review of the literature

Elsayed

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2006

BMC Infect Dis

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Background: Mycobacterium haemophilum is a slow-growing, fastidious, iron-requiring microorganism that, relative to other non-tuberculous mycobacterial species, has rarely been documented as a cause of human infection. This microorganism appears to be acquired via environmental exposure although its natural habitat and mode of acquisition are unknown. It has primarily been implicated as a cause of ulcerating cutaneous or subcutaneous nodular skin lesions, particularly in immunocompromised patients, although infections at extracutaneous sites have also been described. Osteomyelitis, while rarely documented, appears to be an important complication of infection with M. haemophilum in these patients.

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“…[2][3][4][5][6] In Latin America, only two cases have been reported in Brazil. 7 There are no reports from Africa or Asia.…”

Section: Introductionmentioning

confidence: 99%

The diagnosis of two cases of cutaneous ulcer caused by infection with Mycobacterium haemophilum: direct identification in a clinical sample by polymerase chain reaction‐restriction endonuclease analysis

et al. 2008

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Dermatologists should consider this bacterium in immunocompromised patients with cutaneous ulcerating lesions. Material from the lesions can be screened for mycobacteria using an acid-fast stain and, if acid-fast bacilli are seen, PCR analysis of mycobacterial hsp65 can be an effective tool for early diagnosis. Appropriate culture methods are required for bacteriologic confirmation of infection with M. haemophilum.

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Mycobacterium haemophilum: Emerging or Underdiagnosed in Brazil?

Cited by 15 publications

References 8 publications

Application of Real-time PCR to Recognize Atypical Mycobacteria in Archival Skin Biopsies

Application of Real-time PCR to Recognize Atypical Mycobacteria in Archival Skin Biopsies

Mycobacterium haemophilum osteomyelitis: case report and review of the literature

The diagnosis of two cases of cutaneous ulcer caused by infection with Mycobacterium haemophilum: direct identification in a clinical sample by polymerase chain reaction‐restriction endonuclease analysis

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