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MSphere Oct 2018Nodular thelitis is a chronic enzootic infection affecting dairy cows and goats. The causative agent was recently shown to be related to the leprosy-causing bacilli and...
Nodular thelitis is a chronic enzootic infection affecting dairy cows and goats. The causative agent was recently shown to be related to the leprosy-causing bacilli and In this study, the genome of this pathogen was sequenced and analyzed. Phylogenomic analyses confirmed that the pathogen present in nodular thelitis and tuberculoid scrotitis is a distinct species related to the leprosy bacilli and Because the pathogen was originally isolated from a bovine udder, it was named "" The genome of "" is only 3.12 Mb in length, which represents the smallest mycobacterial genome identified so far but which is close to that of leprosy bacilli in size. The genome contains 1,759 protein-coding genes and 1,081 pseudogenes, indicative of extensive reductive evolution and likely the reason that cannot be grown axenically. The pseudogenization and genome reduction in seem to have been to some extent independent from the results determined for the genomes of the leprosy bacilli. is an emerging skin pathogen in dairy animals. Its genome underwent massive reduction and gene decay, leading to a minimal set of genes required for an obligatory intracellular lifestyle, which highly resembles the evolution of the leprosy agents and The genomic similarity between and the leprosy bacilli can help in identifying key virulence factors of these closely related species or in identifying genes responsible for the distinct differences between thelitis or scrotitis and leprosy with respect to clinical manifestations. Specific DNA markers can now be developed for quick detection of this pathogen.
Topics: Animals; Genome, Bacterial; Genomics; Leprosy, Tuberculoid; Livestock; Mycobacterium leprae; Phylogeny; Pseudogenes; Sequence Analysis, DNA; Skin
PubMed: 30282756
DOI: 10.1128/mSphere.00405-18 -
Journal of Clinical Tuberculosis and... Dec 2020Mycobacterium haemophilum is a slow growing nontuberculous mycobacterium which prefers cooler temperatures and requires iron for growth. It usually causes skin and soft...
Mycobacterium haemophilum is a slow growing nontuberculous mycobacterium which prefers cooler temperatures and requires iron for growth. It usually causes skin and soft tissue infections in immunocompromised hosts and cervical lymphadenitis in healthy children. We present the case of fatal disseminated M. haemophilum in an immunocompromised host with central nervous system (CNS) involvement. Our case is a 65-year-old Hispanic male with history of end-stage renal disease status post renal transplantation six years prior (on maintenance immunosuppression with mycophenolate, tacrolimus and prednisone), diabetes mellitus type 2, coronary artery disease, ventricular arrhythmias with implantable cardioverter defibrillator, prior stroke and cochlear implant. In the four months preceding admission to our institution he had frequent hospitalizations for altered mental status (AMS), sepsis syndromes and failure to thrive. Two months prior to presentation he developed progressive swelling and redness of the wrists, right third and left fifth digits. Computed tomography (CT) showed extensive cellulitis in distal right forearm and hand with chronic osteomyelitis. Serial incision and drainage (I&D) of right wrist yielded positive AFB stain and growth on AFB culture. PCR was negative for Mycobacterium tuberculosis. Patient was started on rifampin, clarithromycin and ethambutol. Two days later patient developed AMS and severe septic shock requiring transfer to our facility. CT head revealed indeterminate lesion in the left frontal lobe along with nonspecific hypodensities in the pons and thalamus. Repeat CT upper extremities showed osteomyelitis of distal radius and small hand bones with adjacent abscesses. I&D also revealed bilateral tenosynovitis. Cultures were resent. With suspicion for rapidly growing mycobacterial infection, the regimen was changed to linezolid, imipenem and azithromycin. Several changes in antimicrobials were necessary throughout hospitalization due to complicated hospital course. Unfortunately, despite aggressive measures, patient developed multiorgan failure culminating in death 10 days after starting anti-mycobacterial drugs. On the day of death, the organism was identified as M. haemophilum. Susceptibilities were not done as patient had died. On autopsy the brain was noted to have multiple abscesses containing AFB. The organism also grew from the wrists and right finger cultures. M. haemophilum of the CNS is extremely rare and has been reported in HIV or AIDS patients. To our knowledge this is the first reported case of M. haemophilum brain abscesses in a patient without HIV/AIDS. Because of its fastidious growth requirements, M. haemophilum usually shows on acid fast stains but does not grow on routine AFB cultures. Although it prefers lower temperatures for growth and is usually limited to skin and soft tissues, disseminated disease occurs in immunocompromised patients and has high mortality. It is usually treated with a multi drug regimen including clarithromycin, rifampin, ciprofloxacin and amikacin.
PubMed: 33294628
DOI: 10.1016/j.jctube.2020.100197 -
Open Forum Infectious Diseases Apr 2022is a nontuberculous mycobacteria (NTM) with a predilection for skin and soft tissue infection (SSTI) in the immunocompromised host. We report a case of disseminated...
is a nontuberculous mycobacteria (NTM) with a predilection for skin and soft tissue infection (SSTI) in the immunocompromised host. We report a case of disseminated infection initially presenting as a nonresolving subacute cellulitis of bilateral lower extremities. Genetic sequencing was used for final identification, while a commercially available polymerase chain reaction test returned a false-positive result for . Consequently, we highlight the importance of as a major differential diagnosis of SSTI in the immunocompromised host and the need for careful interpretation of rapid diagnostic tests.
PubMed: 35308485
DOI: 10.1093/ofid/ofac074 -
Journal of Veterinary Diagnostic... Nov 2016Mycobacteriosis is infrequently reported in free-ranging sea turtles. Nontuberculous Mycobacterium haemophilum was identified as the causative agent of disseminated...
Mycobacteriosis is infrequently reported in free-ranging sea turtles. Nontuberculous Mycobacterium haemophilum was identified as the causative agent of disseminated mycobacteriosis in a juvenile leatherback turtle (Dermochelys coriacea) that was found stranded on the Atlantic coast of Florida. Disseminated granulomatous inflammation was identified histologically, most notably affecting the nervous system. Identification of mycobacterial infection was based on cytologic, molecular, histologic, and microbiologic methods. Among stranded sea turtles received for diagnostic evaluation from the Atlantic and Gulf of Mexico coasts of the United States between 2004 and 2015, the diagnosis of mycobacteriosis was overrepresented in stranded oceanic-phase juveniles compared with larger size classes, which suggests potential differences in susceptibility or exposure among different life phases in this region. We describe M. haemophilum in a sea turtle, which contributes to the knowledge of diseases of small juvenile sea turtles, an especially cryptic life phase of the leatherback turtle.
Topics: Animals; Diagnosis, Differential; Florida; Mycobacterium Infections; Mycobacterium haemophilum; Turtles
PubMed: 27698171
DOI: 10.1177/1040638716661746 -
The Journal of Dermatology Jan 2018Mycobacterium haemophilum is a slow-growing, non-tuberculous mycobacteria that causes cutaneous infection. We describe a case of cutaneous infection in a 68-year-old...
Mycobacterium haemophilum is a slow-growing, non-tuberculous mycobacteria that causes cutaneous infection. We describe a case of cutaneous infection in a 68-year-old Japanese man with polymyositis. This was caused by M. haemophilum harboring one base insertion in gene sequence. At first, the causal microorganism was misidentified as M. intracellulare by COBAS TaqMan MAI test. However, poor growth on Ogawa media and growth enhancement on 7H11C agar around a hemin-containing disk prompted us to reinvestigate the causal microorganisms, which were revealed to be M. haemophilum. Amplified polymerase chain reaction products were sequenced, and the 16S rRNA gene, rpoB, hsp65 and internal transcribed spacer region sequences showed a 100%, 100%, 99.66% and 99.7% match, respectively, with the corresponding regions of M. haemophilum, but it harbored a novel gene sequence in hsp65. The sequences determined by gene analysis of the M. haemophilum strain were deposited into the International Nucleotide Sequence Database. Although numerous cases of M. haemophilum infection have been reported in other countries, only six cases have been reported in Japan to date. It could be possible that this novel mutation lead to misdiagnosis. As M. haemophilum prefers a lower growth temperature (30-32°C) and it requires iron in the culture medium, M. haemophilum could be misidentified or overlooked. Accordingly, a M. haemophilum infection should be considered in cases of cutaneous infection of the body sites, of which surface temperature is low.
Topics: Aged; Diagnostic Errors; Humans; Male; Mutagenesis, Insertional; Mycobacterium avium-intracellulare Infection; Mycobacterium haemophilum; Polymyositis; Skin Diseases, Bacterial
PubMed: 28771786
DOI: 10.1111/1346-8138.13988 -
IDCases 2023is an increasingly recognized pathogen of the non-tuberculous mycobacteria family that largely infects immunocompromised adults and immunocompetent children. is a...
is an increasingly recognized pathogen of the non-tuberculous mycobacteria family that largely infects immunocompromised adults and immunocompetent children. is a fastidious and slow-growing organism that exhibits preferential growth at lower temperature with iron supplemented media, and therefore most clinical manifestations involve cutaneous infection or musculoskeletal infection of the distal extremities. It is believed that opportunistic infection occurs in immunocompromised hosts when the organism is acquired through environmental exposure. We describe the case of a 71-year-old renal transplant recipient who developed acute osteomyelitis of the left foot, likely contracted from Epsom salt soaks with contaminated tap water. Outcomes of infection are generally favorable in the literature. Our patient was treated with local debridement and partial amputation followed by a 3-drug anti-mycobacterial regimen until definitive amputation could be completed.
PubMed: 36687370
DOI: 10.1016/j.idcr.2023.e01684 -
Acta Neuropathologica Communications May 2020Infections by opportunistic non-tuberculous mycobacteria (NTM) are rising in global incidence. One emerging, slowly growing NTM is Mycobacterium haemophilum, which can...
Infections by opportunistic non-tuberculous mycobacteria (NTM) are rising in global incidence. One emerging, slowly growing NTM is Mycobacterium haemophilum, which can cause skin, lung, bone, and soft tissue infections in immunocompromised patients as well as lymphadenitis in immunocompetent individuals. Detection of this microorganism is difficult using conventional culture-based methods and few reports have documented involvement of this pathogen within the central nervous system (CNS).We describe the neuropathologic autopsy findings of a 39-year-old man with AIDS who died secondary to M. haemophilum CNS infection. He initially presented with repeated bouts of pyrexia, nausea and vomiting, and altered mental status that required numerous hospitalizations. CSF infectious workups were consistently negative. His most recent admission identified hyperintensities within the brainstem by MRI and despite antibiotic therapies for suspected CNS infection, he died. Autopsy revealed a swollen brain with marked widening of the brainstem. Microscopic examination of the brain and spinal cord showed focal lymphohistiocytic infiltrates, gliosis and neuronal loss that were associated with acid-fast bacilli (AFB). The brainstem was the most severely damaged and AFB were found to congregate along arterial territories lending support to the notion of hematogenous spread as a mechanism for the organisms' dissemination. 16S rRNA sequencing on formalin-fixed paraffin-embedded tissue enabled post-mortem identification of M. haemophilum. This sequencing methodology may permit diagnosis on CSF intra-vitam.
Topics: Acquired Immunodeficiency Syndrome; Adult; Brain Stem; Humans; Infectious Encephalitis; Male; Meningoencephalitis; Mycobacterium Infections; Mycobacterium haemophilum
PubMed: 32430060
DOI: 10.1186/s40478-020-00937-2 -
Cutis Oct 2019Mycobacterium haemophilum is a nontuberculous organism that commonly manifests as cutaneous lesions and subcutaneous nodules in immunosuppressed adults. Because M...
Mycobacterium haemophilum is a nontuberculous organism that commonly manifests as cutaneous lesions and subcutaneous nodules in immunosuppressed adults. Because M haemophilum infection is rare, the epidemiology, reservoir, and mode of transmission remain largely unknown. Infection presents a challenge to the dermatology community because it is infrequently suspected and commonly misidentified, resulting in delayed diagnosis. We discuss 3 cases of cutaneous M haemophilum infection to better understand clinical presentation, diagnosis, and management.
Topics: Aged; Female; Humans; Male; Mycobacterium Infections; Mycobacterium haemophilum; Skin Diseases, Bacterial; Upper Extremity
PubMed: 31774883
DOI: No ID Found -
Journal Der Deutschen Dermatologischen... Oct 2020
PubMed: 32666629
DOI: 10.1111/ddg.14177 -
Iranian Journal of Kidney Diseases Oct 2018Mycobacterium haemophilum is a fastidious nontuberculosis Mycobacterium that must be considered in the differential diagnosis of infections in immunocompromised...
Mycobacterium haemophilum is a fastidious nontuberculosis Mycobacterium that must be considered in the differential diagnosis of infections in immunocompromised patients. Mycobacterium haemophilum typically is a pathogen of the cutaneous or subcutaneous tissue and also presents as septic arthritis, osteomyelitis, pulmonary disease, and lymphadenitis. We report a 32-year-old man with past medical history of kidney transplantation, endocarditis, gastrointestinal bleeding, and hypertension, complaining of multiple painful nodular lesions since 3 months earlier. A tissue biopsy and polymerase chain reaction detected Mycobacterium haemophilum. Atypical mycobacterial species like Mycobacterium haemophilum should be assessed in immunocompromised patients positive for acid fast staining and negative for Mycobacterium tuberculosis.
Topics: Adult; Anti-Bacterial Agents; Cellulitis; Humans; Immunocompromised Host; Kidney Transplantation; Male; Mycobacterium Infections; Mycobacterium haemophilum
PubMed: 30367024
DOI: No ID Found