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IDCases 2020is a slow growing acid-fast bacillus (AFB) in the nontuberculous mycobacteria (NTM) group. typically causes cervicofacial lymphadenitis in children, cutaneous...
is a slow growing acid-fast bacillus (AFB) in the nontuberculous mycobacteria (NTM) group. typically causes cervicofacial lymphadenitis in children, cutaneous diseases, septic arthritis and osteomyelitis. However, it rarely causes isolated spinal cord disease. We report the first case, to our knowledge, of isolated intramedullary spinal lesions secondary to . This case involved a patient with newly diagnosed human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). He developed significant immune reconstitution inflammatory syndrome (IRIS) during his treatment. should be on the differential for isolated intramedullary spinal lesions, particularly in immunocompromised patients. Given our patient's severe IRIS, patients with HIV and infection should be closely monitored for IRIS and treated aggressively. In high risk circumstances such as spinal disease in patients with HIV, clinicians should consider pre-emptive treatment for IRIS.
PubMed: 32226763
DOI: 10.1016/j.idcr.2019.e00674 -
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 -
Indian Journal of Dermatology,... 2020
Topics: Female; Humans; Immunocompromised Host; Middle Aged; Mycobacterium Infections; Mycobacterium haemophilum; Skin Diseases, Bacterial
PubMed: 31898640
DOI: 10.4103/ijdvl.IJDVL_736_17 -
Revista Do Instituto de Medicina... 2019Mycobacterium haemophilum is a nontuberculous mycobacterium that causes localized or disseminated disease, mainly in immunocompromised hosts. We report the case of a...
Mycobacterium haemophilum is a nontuberculous mycobacterium that causes localized or disseminated disease, mainly in immunocompromised hosts. We report the case of a 35-year-old HIV-infected woman who presented with several enlarging cutaneous lesions over the arms and legs. Histopathological examination revealed the diagnosis of a cutaneous mycobacterial disease. Mycobacterial analyses unveiled M. haemophilum infection. Six months after completion of a successful antimycobacterial treatment, she developed an immune reconstitution inflammatory syndrome (IRIS). This paradoxical relapse presented as tenderness, redness and swelling at the precise sites of the healed lesions and took place in the setting of significant recovery of the CD4 cell count (from 05 to 318 cells/mm 3 ). Microbiological analyses of these worsening lesions were negative, and they spontaneously remitted without the initiation of a novel antimycobacterial treatment cycle. M. haemophilum infection should always be considered as a cause of skin lesions in immunocompromised subjects. Physicians should be aware of the possibility of IRIS as a complication of successful antiretroviral therapy in HIV-infected patients with M. haemophilum infection.
Topics: AIDS-Related Opportunistic Infections; Adult; Anti-Retroviral Agents; CD4 Lymphocyte Count; Female; Humans; Immune Reconstitution Inflammatory Syndrome; Immunocompromised Host; Male; Mycobacterium Infections; Mycobacterium haemophilum
PubMed: 31859848
DOI: 10.1590/S1678-9946201961071 -
Journal of Korean Medical Science Dec 2019Nontuberculous mycobacteria (NTM) lymphadenitis is an under-recognized entity, and data of the true burden in children are limited. Without a high index of suspicion,...
BACKGROUND
Nontuberculous mycobacteria (NTM) lymphadenitis is an under-recognized entity, and data of the true burden in children are limited. Without a high index of suspicion, diagnosis may be delayed and microbiological detection is challenging. Here, we report a cluster of NTM lymphadenitis experienced in Korean children.
METHODS
Subjects under 19 years of age diagnosed with NTM lymphadenitis during November 2016-April 2017 and April 2018 were included. Electronic medical records were reviewed for clinical, laboratory and pathological findings. Information regarding underlying health conditions and environmental exposure factors was obtained through interview and questionnaires.
RESULTS
A total of ten subjects were diagnosed during 18 months. All subjects were 8-15 years of age, previously healthy, male and had unilateral, nontender, cervicofacial lymphadenitis for more than 3 weeks with no significant systemic symptoms and no response to empirical antibiotics. Lymph nodes involved were submandibular (n = 8), preauricular (n = 6) and submental (n = 1). Five patients had two infected nodes and violaceous discoloration was seen in seven subjects. Biopsy specimens revealed chronic granulomatous inflammation and acid-fast bacteria culture identified in two cases and NTM polymerase chain reaction was positive in two cases. Survey revealed various common exposure sources.
CONCLUSION
NTM lymphadenitis is rare but increasing in detection and it may occur in children and adolescents. Diagnosis requires high index of suspicion and communication between clinicians and the laboratory is essential for identification of NTM.
Topics: Adolescent; Anti-Bacterial Agents; Child; Humans; Lymphadenitis; Male; Mycobacterium Infections, Nontuberculous; Mycobacterium haemophilum; Nontuberculous Mycobacteria; RNA, Bacterial
PubMed: 31779059
DOI: 10.3346/jkms.2019.34.e302 -
BMJ Case Reports Nov 2019is a rare pathogen, predominately present in the immunocompromised population. It is especially studied in HIV and haematological malignancy patients. Given its unique...
is a rare pathogen, predominately present in the immunocompromised population. It is especially studied in HIV and haematological malignancy patients. Given its unique living conditions, it is often difficult to establish its diagnosis, but it is often suspected by its classic association with ulcerating skin findings. Our case is unique in that our patient is immunocompromised by his rheumatoid arthritis treatment, and presented without any skin lesions, but was found to have this rare pathogen causing a constellation of unusual symptoms.
Topics: Adalimumab; Adult; Antirheumatic Agents; Arthritis, Rheumatoid; Diagnosis, Differential; Humans; Immunocompromised Host; Lymph Nodes; Male; Mediastinal Diseases; Mycobacterium Infections; Mycobacterium haemophilum
PubMed: 31753822
DOI: 10.1136/bcr-2019-230871 -
Emerging Infectious Diseases Sep 2019Mycobacterium haemophilum is a nontuberculous mycobacterium that can infect immunocompromised patients. Because of special conditions required for its culture, this...
Mycobacterium haemophilum is a nontuberculous mycobacterium that can infect immunocompromised patients. Because of special conditions required for its culture, this bacterium is rarely reported and there are scarce data for long-term outcomes. We conducted a retrospective study at Siriraj Hospital, Bangkok, Thailand, during January 2012-September 2017. We studied 21 patients for which HIV infection was the most common concurrent condition. The most common organ involvement was skin and soft tissue (60%). Combination therapy with macrolides and fluoroquinolones resulted in a 60% cure rate for cutaneous infection; adding rifampin as a third drug for more severe cases resulted in modest (66%) cure rate. Efficacy of medical therapy in cutaneous, musculoskeletal, and ocular diseases was 80%, 50%, and 50%, respectively. All patients with central nervous system involvement showed treatment failures. Infections with M. haemophilum in HIV-infected patients were more likely to have central nervous system involvement and tended to have disseminated infections and less favorable outcomes.
Topics: Adult; Aged; Anti-Bacterial Agents; Cohort Studies; Female; HIV Infections; Humans; Immunocompromised Host; Male; Middle Aged; Mycobacterium Infections; Mycobacterium haemophilum; Retrospective Studies; Thailand; Treatment Outcome
PubMed: 31441427
DOI: 10.3201/eid2509.190430