<i>Mycobacterium szulgai</i>: an unusual cause of skin and soft tissue infection after breast augmentation

Torres-Coy, Jesus A.; Carrera, Carolina Andrea Urbina; Rodríguez-Castillo, Bárbara A.; Ramírez-Murga, Rosalicia; Ortiz-Cáceres, William; Pérez-Alfonzo, Ricardo; Waard, Jacobus H. de

doi:10.1111/ijd.13605

Cited by 6 publications

(3 citation statements)

References 10 publications

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“…While most of the reported cases of M. szulgai include patients who are immunocompromised, a small number of the reported infections occurred in seemingly fully immunocompetent people [ 8 - 10 ]. Both of the patients we presented were immunocompromised and undergoing immune-modulating therapy.…”

Section: Discussionmentioning

confidence: 99%

Two Cases of Cutaneous Mycobacterium szulgai Infection

Rodriguez¹,

Lee²,

Phillips³

2022

Cureus

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Although nontuberculous mycobacteria (NTM) infection is often thought of as a pulmonary disease, it can manifest on the skin in rare cases. In this report, we describe two cases of cutaneous Mycobacterium szulgai that presented as nonhealing rashes that were initially thought to be caused by bacterial cellulitis but did not respond to broad-spectrum antibiotics. In both cases, the rash began on the upper extremities. We believe that these cases will be of interest as they demonstrate a rare cutaneous infection and an unusual presentation for NTM. It is important to consider NTM, and M. szulgai specifically, in an immunocompromised patient with a nonhealing rash and initiate appropriate diagnostic studies.

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Section: Discussionmentioning

confidence: 99%

Two Cases of Cutaneous Mycobacterium szulgai Infection

Rodriguez¹,

Lee²,

Phillips³

2022

Cureus

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“…The identification of our isolates showed that many species are hardly mentioned in the medical literature and are relatively unknown as infectious agents for humans. Examples include the species M. porcinum, M. simiae, M. thermoresistibile, M. neoaurum, and M. szulgai [ 22 , 23 ]. Some strains ( Supplementary Table S1 and Figure 1 and Figure 2 ) were unidentifiable because the percentages of divergence were considerably higher than 1.328%, so these could be new mycobacterial species or variants of already known species, or the references sequences were not considered in the phylogenetic analysis.…”

Section: Discussionmentioning

confidence: 99%

The Re-Identification of Previously Unidentifiable Clinical Non-Tuberculous Mycobacterial Isolates Shows Great Species Diversity and the Presence of Other Acid-Fast Genera

et al. 2022

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Non-tuberculous mycobacteria that cannot be identified at the species level represent a challenge for clinical laboratories, as proper species assignment is key to implementing successful treatments or epidemiological studies. We re-identified forty-eight isolates of Ziehl–Neelsen (ZN)-staining-positive “acid-fast bacilli” (AFB), which were isolated in a clinical laboratory and previously identified as Mycobacterium species but were unidentifiable at the species level with the hsp65 PCR restriction fragment length polymorphism analysis (PRA). As most isolates also could not be identified confidently via 16S, hsp65, or rpoB DNA sequencing and a nBLAST search analysis, we employed a phylogenetic method for their identification using the sequences of the 16S rDNA, which resulted in the identification of most AFB and a Mycobacterium species diversity not found before in our laboratory. Most were rare species with only a few clinical reports. Moreover, although selected with the ZN staining as AFB, not all isolates belonged to the genus Mycobacterium, and we report for the first time in Latin America the isolation of Nocardia puris, Tsukamurella pulmosis, and Gordonia sputi from sputum samples of symptomatic patients. We conclude that ZN staining does not differentiate between the genus Mycobacterium and other genera of AFB. Moreover, there is a need for a simple and more accurate tree-based identification method for mycobacterial species. For this purpose, and in development in our lab, is a web-based identification system using a phylogenetic analysis (including all AFB genera) based on 16S rDNA sequences (and in the future multigene datasets) and the closest relatives.

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“…NTM infections have been reported frequently and are mostly associated with trauma or plastic surgery and cosmetic procedures. In Venezuela, authors (including ourselves) have reported NTM infection following mesotherapy, acupuncture treatment, breast implants and liposuction [1][2][3][4][5]. As far as we know, infections due to NTM as a result of a dental procedure and presenting as cutaneous dental sinus tract have never been reported in the English medical literature.…”

Section: Introductionmentioning

confidence: 97%

Odontogenic cutaneous sinus tracts due to infection with nontuberculous mycobacteria: a report of three cases

et al. 2020

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Background: Soft tissue or skin infections due to nontuberculous mycobacteria (NTM) have been reported frequently and are mostly associated with trauma or cosmetic interventions like plastic surgery. However, infection with NTM as a result of a dental procedure have rarely been described and the lack of clinical suspicion and a clear clinical manifestation makes diagnosis challenging. Case presentation: We report on three patients with a facial cutaneous sinus tract of dental origin, due to an infection with respectively Mycobacterium fortuitum, M. abscessus and M. peregrinum. The infection source was the dental unit waterlines (DUWLs), which were colonized with NTM. Conclusions: Water of the DUWL can pose a health risk. This report emphasizes the need for quality control and certification of water flowing through DUWLs, including the absence of NTM. Our report also shows the need for a rapid recognition of NTM infections and accurate laboratory diagnosis in order to avoid long-term ineffective antibiotic treatment.

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Mycobacterium szulgai: an unusual cause of skin and soft tissue infection after breast augmentation

Cited by 6 publications

References 10 publications

Two Cases of Cutaneous Mycobacterium szulgai Infection

Two Cases of Cutaneous Mycobacterium szulgai Infection

The Re-Identification of Previously Unidentifiable Clinical Non-Tuberculous Mycobacterial Isolates Shows Great Species Diversity and the Presence of Other Acid-Fast Genera

Odontogenic cutaneous sinus tracts due to infection with nontuberculous mycobacteria: a report of three cases

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