Sporotrichoide atypische Mykobakterien

Bormann, Gisela; Wc, Marsch

doi:10.1007/s00105-003-0679-y

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…A second patient was treated with clarithromycin (500 mg/day for 5 months), with progressive improvement; however, it was necessary to stop the therapy because of persistent nausea [15]. Clarithromycin monotherapy was subsequently used in some anecdotical cases or very small groups of patients at daily doses ranging from 500 mg to 1 g, and for changeable length (from 12 to 281 days, although most authors used the drug for 2-3 months) [12,16,17,18,19,20,21,22,23,24,25,26,27,28]. In most of the patients, except for rare cases in whom clarithromycin was employed at a dose of 1 g/day [13,25,26,27], complete recovery was observed.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Sporotrichoid Fish Tank Granuloma with Pulsed Clarithromycin

Veraldi¹,

Çuka²,

Nazzaro³

2014

Dermatology

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Background: There is no established therapy of choice for Mycobacterium marinum skin infections; clarithromycin monotherapy was used in some anecdotical cases at changeable daily doses and length. Objective: To evaluate the efficacy and safety of pulsed clarithromycin monotherapy. Methods: 29 patients with a clinical diagnosis of sporotrichoid fish tank granuloma were admitted from 2002 to 2013. In 14 patients, the clinical diagnosis was confirmed by history, histopathology and bacteriological examinations. All patients were treated with clarithromycin (500 mg/day for 10 consecutive days/month for 5 months). Results: In 12 out of 14 patients (85.7%) complete clinical remission was recorded. Two patients showed partial remission after 3 months of therapy, but they were lost to follow-up and were therefore not considered evaluable. Conclusion: Our study suggests that pulsed clarithromycin monotherapy is effective and safe in sporotrichoid M. marinum skin infections.

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Section: Discussionmentioning

confidence: 99%

Treatment of Sporotrichoid Fish Tank Granuloma with Pulsed Clarithromycin

Veraldi¹,

Çuka²,

Nazzaro³

2014

Dermatology

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Atypische Mykobakteriose der Haut durch Mycobacterium abscessus bei einer immunkompetenten Frau

Nenoff¹,

Uhlemann

Grünewald

et al. 2007

Hautarzt

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Mycobacterium abscessus is the most pathogenic of the fast-growing mycobacteria, and it is resistant to most of the antimicrobial and tuberculostatic drugs available. This non-tuberculous mycobacterium is significant in medicine because it can contaminate post-traumatic wounds and be a causative agent in chronic skin and soft tissue infection after surgical procedures.A 60-year-old immunocompetent woman was suffering from chronic ulcers and abscesses on the heels and malleoli of both feet. Histological examination revealed a granulomatous inflammation with detection of acid-fast rods, albeit without fibrinoid necrosis. The repeated detection of atypical mycobacteria, which were ultimately identified as Mycobacterium abscessus, allowed the diagnosis of an atypical mycobacteriosis of the skin. This was successfully treated first with clarithromycin and rifabutin and later with a combination of ethambutol, minocycline, clofazimine and azithromycin.

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Treatment ofMycobacterium marinumcutaneous infections

Rallis

Koumantaki-Mathioudaki

2007

Expert Opinion on Pharmacotherapy

119

101

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Mycobacterium marinum is a non-tuberculous mycobacterium found in non-chlorinated water, with worldwide prevalence. It is the most common atypical Mycobacterium that causes opportunistic infection in humans. It presents as a solitary, red-to-violaceous plaque or nodule with an overlying crust or verrucous surface, or as inflammatory nodules or abscesses, usually in a sporotrichotic type of distribution. Deep infections may also occur. Although diagnosis is confirmed by isolation and identification of the organism in practice diagnosis remains largely presumptive based on clinicohistological features and the response to treatment. Polymerase chain reaction allows the routine early detection of the organism from a biopsy specimen. In the near future, it seems possible that histopathological examination might be greatly assisted by the rapidly improving possibilities with in vivo imaging. There have been many therapeutic modalities used effectively in the treatment of M. marinum infections. Spontaneous remission has also been reported in untreated infections and in immunocompetent hosts. However, there is no proven treatment of choice because M. marinum is naturally multi-drug resistant species and treatment is based primarily on the personal experience and preference of individual investigators, without the benefit of large studies. In superficial cutaneous infections minocycline, clarithromycin, doxycycline and trimethoprim-sulfamethoxazole as monotherapy are effective treatment options, but drug resistance varies and thereby combination therapy usually of two drugs may be required. Ciprofloxacin has shown considerable effectiveness. In cases of severe infections, including those with a sporotrichoid distribution pattern, a combination of rifampicin and ethambutol seems to be the recommended regimen. The use of isoniazid, streptomycin and pyrazinamide as empirical treatment options should be avoided. Surgical treatment is not usually recommended and must be cautiously applied. Cryotherapy, X-ray therapy, electrodesiccation, photodynamic therapy and local hyperthermic therapy have been reported as effective therapeutic alternatives. M. marinum infection should always be included in the differential diagnosis of all cases with poor-healing wounds in upper extremities and a history of exposure to aquariums.

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Sporotrichoide atypische Mykobakterien

Cited by 3 publications

References 18 publications

Treatment of Sporotrichoid Fish Tank Granuloma with Pulsed Clarithromycin

Treatment of Sporotrichoid Fish Tank Granuloma with Pulsed Clarithromycin

Atypische Mykobakteriose der Haut durch Mycobacterium abscessus bei einer immunkompetenten Frau

Treatment ofMycobacterium marinumcutaneous infections

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