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Veterinary Clinical Pathology Jun 2023A 4-year-old female spayed Australian cattle dog was presented to the Emergency Service at the University of Missouri Veterinary Health Center Small Animal Hospital for...
A 4-year-old female spayed Australian cattle dog was presented to the Emergency Service at the University of Missouri Veterinary Health Center Small Animal Hospital for generalized pain and lethargy. At presentation, the dog showed severe cervical spinal pain and thoracic limb deficits consistent with a multifocal neuroanatomic localization. Magnetic resonance imaging of the cervical spine revealed T2 and T1 postcontrast intense signal extending from the level of the medulla through C5 most marked in the caudal brainstem and cranial cervical spinal cord. The suspected diagnosis was severe meningoencephalomyelitis and secondary edema. Analysis of cerebrospinal fluid (CSF) collected from the cerebellomedullary cistern revealed a marked mixed pleocytosis with intralesional structures morphologically consistent with Mycobacterium sp. Standard DNA PCR assay performed on the CSF yielded the presence of Mycobacterium haemophilum. To the authors' knowledge, this is the first reported case of CNS mycobacteriosis diagnosed on CSF analysis in a dog.
Topics: Female; Cattle; Dogs; Animals; Mycobacterium haemophilum; Australia; Spinal Cord; Magnetic Resonance Imaging; Leukocytosis; Dog Diseases; Cerebrospinal Fluid; Cattle Diseases
PubMed: 36931892
DOI: 10.1111/vcp.13206 -
Infectious Diseases (London, England) Jul 2023is a nontuberculous mycobacterium with fastidious growth requirements and an increasingly reported cause of extrapulmonary disease. Timely diagnosis and management of...
BACKGROUND
is a nontuberculous mycobacterium with fastidious growth requirements and an increasingly reported cause of extrapulmonary disease. Timely diagnosis and management of infections and the immune reconstitution inflammatory syndromes (IRIS) observed in a subset of patients during treatment remain challenging.
METHODS
We conducted a retrospective chart review between January 1, 2010, and January 1, 2022 and identified 26 patients diagnosed with infection at our institution. We describe their clinical presentation, diagnostic results, management, and outcomes.
RESULTS
The majority of patients in our cohort had upper and/or lower extremity skin involvement, were immunosuppressed, and had generally favourable treatment outcomes. All tested isolates were susceptible to clarithromycin and trimethoprim-sulfamethoxazole. Moreover, high rates of susceptibility were noted for ciprofloxacin (95%), linezolid (90%), and rifampin (85%). IRIS was identified in 31% of cases and should be considered in patients who develop worsening skin lesions or systemic symptoms following the initiation of effective antimicrobial therapy. Visualisation of acid-fast bacilli on initial tissue stains, a positive mycobacterial blood culture, and rapid de-escalation of tumour necrosis factor-α inhibitors and/or corticosteroids were more frequently encountered among patients in our cohort who developed IRIS.
CONCLUSION
infection should be considered among patients receiving immunomodulatory therapy who develop discoloured or nodular skin lesions involving the extremities, worsening focal arthritis, tenosynovitis, or isolated adenopathy. A heightened awareness of this pathogen's clinical and laboratory characteristics can lead to a timely diagnosis and favourable outcome.
Topics: Humans; Immune Reconstitution Inflammatory Syndrome; Mycobacterium haemophilum; Mycobacterium Infections; Retrospective Studies; Treatment Outcome
PubMed: 37151046
DOI: 10.1080/23744235.2023.2208210 -
Journal of Fish Diseases Jun 2020The use of zebrafish (Danio rerio) in biomedical research has expanded at a tremendous rate over the last two decades. Along with increases in laboratories using this... (Review)
Review
The use of zebrafish (Danio rerio) in biomedical research has expanded at a tremendous rate over the last two decades. Along with increases in laboratories using this model, we are discovering new and important diseases. We review here the important pathogens and diseases based on some 20 years of research and findings from our diagnostic service at the NIH-funded Zebrafish International Resource Center. Descriptions of the present status of biosecurity programmes and diagnostic and treatment approaches are included. The most common and important diseases and pathogens are two parasites, Pseudoloma neurophilia and Pseudocapillaria tomentosa, and mycobacteriosis caused by Mycobacterium chelonae, M. marinum and M. haemophilum. Less common but deadly diseases are caused by Edwardsiella ictaluri and infectious spleen and kidney necrosis virus (ISKNV). Hepatic megalocytosis and egg-associated inflammation and fibroplasia are common, apparently non-infectious, in zebrafish laboratories. Water quality diseases include supersaturation and nephrocalcinosis. Common neoplasms are spindle cell sarcomas, ultimobranchial tumours, spermatocytic seminomas and a small-cell carcinoma that is caused by a transmissible agent. Despite the clear biosecurity risk, researchers continue to use fish from pet stores, and here, we document two novel coccidia associated with significant lesions in zebrafish from one of these stores.
Topics: Animals; Animals, Laboratory; Communicable Disease Control; Fish Diseases; Oregon; Research; Zebrafish
PubMed: 32291793
DOI: 10.1111/jfd.13165 -
Journal Der Deutschen Dermatologischen... Nov 2023
Review
[Hautbeteiligung bei Infektionen mit Mycobacterium haemophilum: Zwei Fallberichte und eine aktualisierte Literaturübersicht: Mycobacterium haemophilum infection with cutaneous involvement: Two case reports and an updated literature review].
PubMed: 37946643
DOI: 10.1111/ddg.15163_g -
Annals of Hematology Feb 2023
Topics: Humans; Alemtuzumab; Leukemia, Prolymphocytic, T-Cell; Mycobacterium haemophilum; Antineoplastic Agents; Mycobacterium Infections, Nontuberculous
PubMed: 36637475
DOI: 10.1007/s00277-022-05053-w -
BMC Infectious Diseases Nov 2020To report three cases of nontuberculous mycobacterial (NTM) endophthalmitis following multiple ocular surgeries and to review previous literature in order to study the... (Review)
Review
BACKGROUND
To report three cases of nontuberculous mycobacterial (NTM) endophthalmitis following multiple ocular surgeries and to review previous literature in order to study the clinical profile, treatment modalities, and visual outcomes among patients with NTM endophthalmitis.
METHODS
Clinical manifestation and management of patients with NTM endophthalmitis in the Department of Ophthalmology, Faculty of Medicine, Siriraj hospital, Mahidol University, Bangkok, Thailand were described. In addition, a review of previously reported cases and case series from MEDLINE, EMBASE, and CENTRAL was performed. The clinical information and type of NTM from the previous studies and our cases were summarized.
RESULTS
We reported three cases of NTM endophthalmitis caused by M. haemophilum, M. fortuitum and M. abscessus and a summarized review of 112 additional cases previously published. Of 115 patients, there were 101 exogenous endophthalmitis (87.8%) and 14 endogenous endophthalmitis (12.2%). The patients' age ranged from 13 to 89 years with mean of 60.5 ± 17.7 years with no gender predominance. Exogenous endophthalmitis occurred in both healthy and immunocompromised hosts, mainly caused by cataract surgery (67.3%). In contrast, almost all endogenous endophthalmitis patients were immunocompromised. Among all patients, previous history of tuberculosis infection was identified in 4 cases (3.5%). Rapid growing NTMs were responsible for exogenous endophthalmitis, while endogenous endophthalmitis were commonly caused by slow growers. Treatment regimens consisted of macrolides, fluoroquinolones or aminoglycosides, which were continued for up to 12 months. Initial and final vision were generally worse than 6/60.
CONCLUSIONS
NTM endophthalmitis is a serious intraocular infection that leads to irreversible loss of vision. The presentation can mimic a chronic recurrent or persistent intraocular inflammation. History of multiple intraocular surgeries or immune-deficiency in patient with chronic panuveitis should raise the practioner's suspicion of NTM endophthalmitis. Appropriate diagnosis and treatment are important to optimize visual outcome.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Aminoglycosides; Anti-Bacterial Agents; Cataract Extraction; Endophthalmitis; Female; Fluoroquinolones; Humans; Immunocompromised Host; Macrolides; Male; Middle Aged; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Postoperative Complications; Thailand; Treatment Outcome; Young Adult
PubMed: 33228593
DOI: 10.1186/s12879-020-05606-2 -
Medicine Mar 2020A remarkable increase in the prevalence of cutaneous nontuberculous mycobacterial (NTM) infection has occurred worldwide. However, updated data regarding cutaneous NTM...
A remarkable increase in the prevalence of cutaneous nontuberculous mycobacterial (NTM) infection has occurred worldwide. However, updated data regarding cutaneous NTM infection in Thailand is limited.This study aim to describe the clinical manifestations, pathogenic organism, and prognostic factors of cutaneous NTM infections among patients living in Thailand.The electronic medical records of all patients with confirmatory diagnosis of cutaneous NTM infection from either positive cultures or polymerase chain reaction were retrospectively reviewed at a university-based hospital.From 2011 to 2017, a total of 88 patients with a confirmed diagnosis of cutaneous NTM infection were included. Mycobacterium abscessus was the most common pathogens followed by M haemophilum and M marinum (61.4%, 10.2%, and 8.1%, respectively). Nodule and plaque were 2 most common lesions (26.4% and 25.5%, respectively) and lower leg is the most common site of involvement (50.9%). The majority of patients presented with single lesion (67%). Seven patients (7.9%) had history of surgical procedure and/or cosmetic injection before the development of lesion and all pathogenic organisms in this group were rapidly growing mycobacteria. Sweet's syndrome and erythema nodosum were the 2 most common reactive dermatoses, presented in 3.4% and 2.3%, respectively. The majority of patients infected with cutaneous M haemophilum infections were immunocompromised and lacked history of preceding trauma (77.8%). Patients with cutaneous NTM that receiving less than 3 medications was associated with higher disease relapse (odds ratio 65.86; P = .02).M abscessus is the most common pathogen of cutaneous NTM infection in Thailand. The prevalence of M haemophilum is increasing and should be particularly cautious in immunocompromised patients. Rapidly growing mycobacteria should be suspected in all cases of procedure-related cutaneous NTM. We recommend at least 3 antibiotics should be considered for cutaneous NTM infection to reduce the rate of relapse.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antifungal Agents; Child; Child, Preschool; Female; Humans; Male; Middle Aged; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Odds Ratio; Prevalence; Retrospective Studies; Thailand
PubMed: 32150075
DOI: 10.1097/MD.0000000000019355 -
Rheumatology International Oct 2019To investigate the clinical manifestations and outcomes of musculoskeletal (MSK) nontuberculous mycobacterium (NTM) infections. This study was a retrospective cohort...
To investigate the clinical manifestations and outcomes of musculoskeletal (MSK) nontuberculous mycobacterium (NTM) infections. This study was a retrospective cohort study using the Siriraj Hospital database from 2005 to 2017. Enrolled were all patients aged 15 or older who had an MSK infection with NTM identified in synovial fluid, pus, or tissue by an acid-fast bacilli stain, culture, or polymerase chain reaction. Of 1529 cases who were diagnosed with NTM infections, 39 (2.6%) had an MSK infection. However, only 28 patients met our inclusion criteria. Their mean age (SD) was 54.1 (16.1) years, and half were male. Of this cohort, 25% had previous musculoskeletal trauma, 18% prior bone and joint surgery, 14% prosthetic joint replacement, and 11% HIV infection. The median symptom duration (IQR) was 16 (37.4) weeks. The most common MSK manifestation was arthritis (61%), followed by osteomyelitis (50%), tenosynovitis (25%), and spondylodiscitis (14%). The most common organism was M. abscessus (18%), and M. kansasii (18%), followed by M. intracellulare (14%), M. marinum (14%), M. fortuitum (7%), and M. haemophilum (7%). In addition to medical treatment, most patients underwent surgery (82%), comprising debridement, osteotomy, prosthesis removal, and amputation, while 18% received only medical treatment. The treatment outcomes were complete recovery in 46%, improvement with some residual disability and deformities in 29%, and death in 3.6%. Musculoskeletal NTM infections were uncommon. Most patients had underlying joint disease or were immunocompromised hosts. Surgical management, as an adjunct to medical therapy, was necessary.
Topics: Adult; Aged; Anti-Bacterial Agents; Arthritis, Infectious; Combined Modality Therapy; Databases, Factual; Discitis; Female; Humans; Male; Middle Aged; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Orthopedic Procedures; Osteomyelitis; Recovery of Function; Remission Induction; Retrospective Studies; Risk Factors; Tenosynovitis; Thailand; Time Factors; Treatment Outcome
PubMed: 31352560
DOI: 10.1007/s00296-019-04392-8 -
The Medical Journal of Australia Oct 2022
Topics: Humans; Mycobacterium haemophilum; Inflammatory Bowel Diseases; Crohn Disease; Mycobacterium Infections
PubMed: 36104022
DOI: 10.5694/mja2.51720 -
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