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BMC Infectious Diseases Apr 2023Opportunistic infection is an under-recognized complication of Cushing's syndrome, with infection due to atypical mycobacterium rarely reported. Mycobacterium szulgai... (Review)
Review
BACKGROUND
Opportunistic infection is an under-recognized complication of Cushing's syndrome, with infection due to atypical mycobacterium rarely reported. Mycobacterium szulgai commonly presents as pulmonary infection, with cutaneous infection seldom reported in the literature.
CASE PRESENTATION
48-year-old man with a newly-diagnosed Cushing's syndrome secondary to adrenal adenoma presented with a subcutaneous mass on the dorsum of his right hand, was diagnosed with cutaneous Mycobacterium szulgai infection. The most likely source of the infection was through minor unnoticed trauma and inoculation from a foreign body. The patient's Cushing's syndrome, high serum cortisol levels and secondary immune suppression facilitated mycobacterial replication and infection. The patient was successfully treated with adrenalectomy, surgical debridement of cutaneous lesion, and a combination of rifampicin, levofloxacin, clarithromycin, and ethambutol for 6 months. There were no signs of relapse one year after cessation of anti-mycobacterial treatment. A literature review on cutaneous M. szulgai infection to further characterize the clinical characteristics of this condition, identified 17 cases of cutaneous M. szulgai infection in the English literature. Cutaneous M. szulgai infections with subsequent disease dissemination are commonly reported in immunocompromised hosts (10/17, 58.8%), as well as in immunocompetent patients with a history of breached skin integrity, such as invasive medical procedures or trauma. The right upper extremity is the most commonly involved site. Cutaneous M. szulgai infection is well controlled with a combination of anti-mycobacterial therapy and surgical debridement. Disseminated infections required a longer duration of therapy than localized cutaneous infections. Surgical debridement may shorten the duration of antibiotics.
CONCLUSIONS
Cutaneous M. szulgai infection is a rare complication of adrenal Cushing's syndrome. Further studies are needed to provide evidence-based guidelines on the best combination of anti-mycobacterial and surgical therapy for managing this rare infective complication.
Topics: Male; Humans; Middle Aged; Cushing Syndrome; Nontuberculous Mycobacteria; Mycobacterium Infections, Nontuberculous; Mycobacterium; Skin Diseases, Bacterial
PubMed: 37101119
DOI: 10.1186/s12879-023-08253-5 -
Der Pathologe Feb 2021The detection of Mycobacterium tuberculosis complex DNA by PCR using formalin-fixed paraffin-embedded material has become an integral part of molecular-pathological... (Review)
Review
[Mycobacterium szulgai as positive control helps to detect contaminations in the detection of Mycobacterium tuberculosis-complex in formalin fixed, paraffin embedded tissues by 16SrDNA PCR].
The detection of Mycobacterium tuberculosis complex DNA by PCR using formalin-fixed paraffin-embedded material has become an integral part of molecular-pathological diagnostics. We describe an approach that enables the detection of contamination by using Mycobacterium szulgai as a positive control, contributing to the reduction of false-positive results.
Topics: DNA, Bacterial; Formaldehyde; Mycobacterium tuberculosis; Nontuberculous Mycobacteria; Paraffin Embedding; Polymerase Chain Reaction; Sensitivity and Specificity
PubMed: 33475807
DOI: 10.1007/s00292-021-00912-1 -
Acta Dermato-venereologica Dec 2019
Review
Topics: Adult; Antitubercular Agents; Biopsy, Needle; Follow-Up Studies; Humans; Immunohistochemistry; Male; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Pneumonia; Risk Assessment; Severity of Illness Index; Skin Diseases, Bacterial; Treatment Outcome
PubMed: 31620801
DOI: 10.2340/00015555-3352 -
The Journal of Infection Sep 1998Mycobacterium szulgai is a rare cause of human infections, and when present it is mostly known to cause lung infection. We report the first case of isolated...
Mycobacterium szulgai is a rare cause of human infections, and when present it is mostly known to cause lung infection. We report the first case of isolated Mycobacterium szulgai osteomyelitis in a 68-year-old woman on chronic immunosuppressive therapy. Review of the literature revealed a total of three other cases of M. szulgai osteomyelitis. In all these cases there was evidence of hematogenous or contiguous spread, including one with extensive dissemination. Pulmonary M. szulgai infections tend to occur in patients with chronic lung disease and/or concomitant lung infections, whereas osteomyelitis tends to occur in patients who have severe immunosuppression secondary to disease or drugs.
Topics: Aged; Female; Humans; Immunocompromised Host; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Osteomyelitis
PubMed: 9821098
DOI: 10.1016/s0163-4453(98)80178-3 -
Microbiology Spectrum Jan 2017Rapidly growing mycobacteria (RGM) compose approximately one-half of the currently validated mycobacterial species and are divided into six major groups, including the... (Review)
Review
Rapidly growing mycobacteria (RGM) compose approximately one-half of the currently validated mycobacterial species and are divided into six major groups, including the Mycobacterium fortuitum group, M. chelonae/M. abscessus complex, M. smegmatis group, M. mucogenicum group, M. mageritense/M. wolinskyi, and the pigmented RGM. This review discusses each group and highlights the major types of infections associated with each group. Additionally, phenotypic and molecular laboratory identification methods, including gene sequencing, mass spectrometry, and the newly emerging whole-genome sequencing, are detailed, along with a discussion of the current antimicrobial susceptibility methods and patterns of the most common pathogenic species.
Topics: Bacteriological Techniques; Diagnostic Tests, Routine; Humans; Molecular Diagnostic Techniques; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria
PubMed: 28084211
DOI: 10.1128/microbiolspec.TNMI7-0027-2016 -
Archives of Ophthalmology (Chicago,... Aug 2000
Topics: Adult; Anti-Bacterial Agents; Clarithromycin; DNA, Bacterial; Eye Infections, Bacterial; Humans; Keratitis; Male; Microbial Sensitivity Tests; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Polymerase Chain Reaction; Visual Acuity
PubMed: 10922211
DOI: 10.1001/archopht.118.8.1123 -
Internal Medicine (Tokyo, Japan) Apr 2000
Review
Topics: Drug Resistance, Microbial; Humans; Lung Diseases; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Rifampin
PubMed: 10801139
DOI: 10.2169/internalmedicine.39.277 -
Infection Aug 2012
Review
Topics: Biopsy; Fatal Outcome; Humans; Leukemia, Myeloid, Acute; Male; Middle Aged; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria
PubMed: 22038111
DOI: 10.1007/s15010-011-0213-6 -
Scientific Reports Mar 2017Mycobacterium tuberculosis and Mycobacterium leprae have remained, for many years, the primary species of the genus Mycobacterium of clinical and microbiological...
Mycobacterium tuberculosis and Mycobacterium leprae have remained, for many years, the primary species of the genus Mycobacterium of clinical and microbiological interest. The other members of the genus, referred to as nontuberculous mycobacteria (NTM), have long been underinvestigated. In the last decades, however, the number of reports linking various NTM species with human diseases has steadily increased and treatment difficulties have emerged. Despite the availability of whole genome sequencing technologies, limited effort has been devoted to the genetic characterization of NTM species. As a consequence, the taxonomic and phylogenetic structure of the genus remains unsettled and genomic information is lacking to support the identification of these organisms in a clinical setting. In this work, we widen the knowledge of NTMs by reconstructing and analyzing the genomes of 41 previously uncharacterized NTM species. We provide the first comprehensive characterization of the genomic diversity of NTMs and open new venues for the clinical identification of opportunistic pathogens from this genus.
Topics: Chromosome Mapping; Gene Transfer, Horizontal; Genetic Variation; Genome, Bacterial; Humans; Molecular Sequence Annotation; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Open Reading Frames; Phylogeny; Sequence Analysis, DNA
PubMed: 28345639
DOI: 10.1038/srep45258 -
Respiration; International Review of... 2003A 75-year-old man was admitted with cough, purulent sputum, fatigue and weight loss of 10 kg of some months' duration. His chest radiograph showed poorly defined... (Review)
Review
A 75-year-old man was admitted with cough, purulent sputum, fatigue and weight loss of 10 kg of some months' duration. His chest radiograph showed poorly defined opacities in the right lung. Eleven years before admission an epidermoid carcinoma of the right lung had been diagnosed and a right bilobar resection had been performed. The patient remained asymptomatic for 8 years. Cultures of 4 consecutive sputum samples were positive for mycobacteria that were identified as Mycobacterium szulgai by gas chromatography. A 6-month regimen of rifampin, isoniazid and pyrazinamide resulted in complete eradication of the mycobacterium. M. szulgai is an unusual pathogen in humans. In the English literature, only 35 cases of pulmonary disease have been reported. Its clinical and radiological characteristics are similar to tuberculosis but in contrast to the rest of the non-tuberculous mycobacteria, M. szulgai has shown in vitro and in vivo susceptibility to most primary antituberculosis drugs.
Topics: Aged; Antitubercular Agents; Drug Therapy, Combination; Humans; Male; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria
PubMed: 14665782
DOI: 10.1159/000074214