Soft tissue infection due to Mycobacterium fortuitum following acupuncture: a case report and review of the literature

Abstract

We report the first case of a post-acupuncture soft tissue infection due to Mycobacterium fortuitum. Two months after finishing an acupuncture treatment session, an immunocompetent 23-year-old woman developed cellulitis at the side of the needle insertions and the acidfast bacillus was isolated from a closed abscess. The patient was successfully treated with a proper drug combination. We review the literature concerning the infection source and the risks for skin and soft tissue infection due to mycobacteria after acupuncture. The infection source in most cases is unknown but is probably associated with the inadequate sterilization of the needles or the puncture site. We show that these infections are not rare but difficult to diagnose. To avoid delays in the definitive diagnosis, infection with mycobacteria should be considered for skin and soft tissue infections, in particular late-onset infections, which are negative for routine bacterial cultures and without a clinical response to antibiotics used for acute pyogenic infections. Bacterial cultures from this lesion should be maintained for at least six weeks before discharged as negative.

Chronic mycobacterial meningitis due to Mycobacterium chelonae: a case report

“…However, these methods are time-consuming and identification of the organism to the species level is not always possible. 3 In many studies, molecular techniques including analyses of the 32-kDa proteinencoding gene, the 16S rRNA gene, dnaJ, recA, sod, and the internal transcribed spacer 16S-23S rRNA (ITS), have been proposed for the molecular identification of clinical isolates of RGM. 10 While soft tissue disease is the most important clinical manifestation of this organism, 3 to date there has been no report of chronic meningitis due to M. chelonae in the world.…”

“…They can cause localized cutaneous infections following trauma, as well as outbreaks of nosocomial infection and pseudo-outbreaks. 3 Surgical site infections with RGM are most often caused by Mycobacterium fortuitum, Mycobacterium chelonae, or Mycobacterium abscessus. 4 Infections caused by M. chelonae usually involve the skin, bone, eye, and soft tissue, and rarely the lungs.…”

Molecular Identification of Clinical Isolates of Mycobacterium fortuitum by Random Amplified Polymorphic DNA (RAPD) Polymerase Chain Reaction and ERIC PCR

“…They are common saprophytes of a wide variety of environmental reservoirs, such as soil, dust and water which act as opportunistic human pathogens in certain circumstances and often emerge in outbreaks. They have been reported to be associated with cutaneous infections [2]. Among NTM, rapidly growing mycobacteria (RGM), can cause localized cutaneous infections following trauma, as well as outbreaks of nosocomial infections including surgical site infections [3].…”

“…M. fortuitum was first isolated from an amphibian source in 1905 and subsequently rediscovered as a human pathogen and named by Da Costa Cruz in 1938 [5]. M. fortuitum can cause a wide range of infections of lungs [6], skin, and soft tissue [7] comprises injection abscesses and wound infections [2,8], tendon sheath [9], breast abscess [10] and bone [11] in immunocompromised hosts including AIDs patients and in patients following cardiac bypass surgery or augmentation mammoplasty [5,12,13]. The molecular typing methods are used for diversity and outbreak investigations of M. fortuitum.…”

Soft Tissue Infection Caused by Rapid Growing Mycobacterium following Medical Procedures: Two Case Reports and Literature Review

“…These organisms are present in or found extremely in the water, the soil, or the nosocomial sources. Several conditions such as mesotherapy, non-sterile venopuncture, acupuncture, or even tattoo, have been reported to cause the infections of these organisms1,3,4,5,6,7. Due to a gradually increasing incidence of the infections of this group8,9, we reported 2 cases of these types of infections, which were characterized as medical procedures associated infections, and reviewed other literatures about these conditions.…”