-
Emerging Infectious Diseases 1999Although most diseases due to pathogenic mycobacteria are caused by Mycobacterium tuberculosis, several other mycobacterial diseases-caused by M. ulcerans (Buruli... (Review)
Review
Although most diseases due to pathogenic mycobacteria are caused by Mycobacterium tuberculosis, several other mycobacterial diseases-caused by M. ulcerans (Buruli ulcer), M. marinum, and M. haemophilum-have begun to emerge. We review the emergence of diseases caused by these three pathogens in the United States and around the world in the last decade. We examine the pathophysiologic similarities of the diseases (all three cause necrotizing skin lesions) and common reservoirs of infection (stagnant or slow-flowing water). Examination of the histologic and pathogenic characteristics of these mycobacteria suggests differences in the modes of transmission and pathogenesis, though no singular mechanism for either characteristic has been definitively described for any of these mycobacteria.
Topics: Disease Reservoirs; Fasciitis, Necrotizing; Humans; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Risk Factors; Skin Ulcer
PubMed: 10341173
DOI: 10.3201/eid0503.990307 -
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 -
BMC Infectious Diseases Feb 2018Although atypical mycobacteria had been increasingly found in various ocular infections in the past decades, a slow-growing Mycobacterium haemophilum (M. haemophilum)...
BACKGROUND
Although atypical mycobacteria had been increasingly found in various ocular infections in the past decades, a slow-growing Mycobacterium haemophilum (M. haemophilum) was scarcely reported. Similar to tuberculous infection, the presentation can masquerade as low-grade granulomatous intraocular inflammation with partial response to corticosteroids. Besides, the special requirements for culture make this pathogen difficult to diagnose. The study aims to report the clinical presentation and notify the awareness of NTM endophthalmitis among clinicians. This is the first case report of late-onset, postoperative M. haemophilum endophthalmitis in the literature.
CASE PRESENTATION
A 66-year-old man with non-insulin-dependent diabetes mellitus (NIDDM) manifested chronic granulomatous inflammation in the left eye after multiple glaucoma surgeries. With a diagnosis of noninfectious panuveitis, he was treated with systemic corticosteroids. The inflammation initially responded to therapy although it subsequently worsened and became purulent endophthalmitis. The vitreous cultures grew M. haemophilum. Intraocular and systemic antimicrobial treatments were administered early, but the patient eventually turned blind.
CONCLUSIONS
M. haemophilum endophthalmitis is a rare but serious intraocular complication leading to loss of vision or eyeball. Awareness of atypical mycobacterial infections is necessary especially in patients with impaired immune function, previous intraocular surgery, and corticosteroid resistance. Proper laboratory investigations and treatments should be performed. However, due to the rarity of the disease, the development of guidelines for its investigation and therapy is still challenging.
Topics: Aged; Anti-Bacterial Agents; Diabetes Mellitus, Type 2; Endophthalmitis; Glaucoma; Humans; Male; Mycobacterium Infections; Mycobacterium haemophilum; Postoperative Complications; Uveitis
PubMed: 29415658
DOI: 10.1186/s12879-018-2985-0 -
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 -
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 -
Emerging Infectious Diseases Sep 2008The database of a major microbiology laboratory in Israel was searched to determine the prevalence of nontuberculous mycobacterial lymphadenitis in immunocompetent...
The database of a major microbiology laboratory in Israel was searched to determine the prevalence of nontuberculous mycobacterial lymphadenitis in immunocompetent children. We observed a 4-fold increase in nontuberculous mycobacteria isolates during 1985-2006, which was attributable mainly to increased detection of Mycobacterium haemophilum starting in 1996.
Topics: Adolescent; Child; Child, Preschool; Female; Humans; Immunocompetence; Infant; Israel; Lymphadenitis; Male; Mycobacterium Infections; Mycobacterium avium Complex; Mycobacterium haemophilum
PubMed: 18760014
DOI: 10.3201/eid1409.070917 -
MBio Nov 2015Mycobacterium haemophilum is an emerging pathogen associated with a variety of clinical syndromes, most commonly skin infections in immunocompromised individuals....
UNLABELLED
Mycobacterium haemophilum is an emerging pathogen associated with a variety of clinical syndromes, most commonly skin infections in immunocompromised individuals. M. haemophilum exhibits a unique requirement for iron supplementation to support its growth in culture, but the basis for this property and how it may shape pathogenesis is unclear. Using a combination of Illumina, PacBio, and Sanger sequencing, the complete genome sequence of M. haemophilum was determined. Guided by this sequence, experiments were performed to define the basis for the unique growth requirements of M. haemophilum. We found that M. haemophilum, unlike many other mycobacteria, is unable to synthesize iron-binding siderophores known as mycobactins or to utilize ferri-mycobactins to support growth. These differences correlate with the absence of genes associated with mycobactin synthesis, secretion, and uptake. In agreement with the ability of heme to promote growth, we identified genes encoding heme uptake machinery. Consistent with its propensity to infect the skin, we show at the whole-genome level the genetic closeness of M. haemophilum with Mycobacterium leprae, an organism which cannot be cultivated in vitro, and we identify genes uniquely shared by these organisms. Finally, we identify means to express foreign genes in M. haemophilum. These data explain the unique culture requirements for this important pathogen, provide a foundation upon which the genome sequence can be exploited to improve diagnostics and therapeutics, and suggest use of M. haemophilum as a tool to elucidate functions of genes shared with M. leprae.
IMPORTANCE
Mycobacterium haemophilum is an emerging pathogen with an unknown natural reservoir that exhibits unique requirements for iron supplementation to grow in vitro. Understanding the basis for this iron requirement is important because it is fundamental to isolation of the organism from clinical samples and environmental sources. Defining the molecular basis for M. haemophilium's growth requirements will also shed new light on mycobacterial strategies to acquire iron and can be exploited to define how differences in such strategies influence pathogenesis. Here, through a combination of sequencing and experimental approaches, we explain the basis for the iron requirement. We further demonstrate the genetic closeness of M. haemophilum and Mycobacterium leprae, the causative agent of leprosy which cannot be cultured in vitro, and we demonstrate methods to genetically manipulate M. haemophilum. These findings pave the way for the use of M. haemophilum as a model to elucidate functions of genes shared with M. leprae.
Topics: Base Sequence; Culture Media; Genome, Bacterial; Heme; Hemoglobins; Humans; Iron; Mycobacterium haemophilum; Mycobacterium leprae; Oxazoles; Phenotype; Sequence Analysis, DNA
PubMed: 26578674
DOI: 10.1128/mBio.01313-15 -
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 -
International Journal of... Dec 2016Mycobacterium haemophilum is a slow-growing nontuberculous mycobacterium (NTM) that can cause ulcerating cutaneous or subcutaneous nodular skin lesions in...
INTRODUCTION
Mycobacterium haemophilum is a slow-growing nontuberculous mycobacterium (NTM) that can cause ulcerating cutaneous or subcutaneous nodular skin lesions in immunocompromised and immunocompetent patients. Acid-fast staining cannot distinguish NTM from M. tuberculosis; culturing at two temperatures with iron-supplemented media and polymerase chain reaction (PCR) are needed for optimal detection of M. haemophilum.
CASE PRESENTATION
A 32-year-old man with end-stage renal disease, undergoing hemodialysis twice a week, presented with multiple, painless, nonpruritic nodular lesions. A formalin-fixed paraffin-embedded tissue block from his finger lesion was sent to the Department of Pathology, Masih Daneshvari Hospital for consultation. The lesions were primarily diagnosed to be dermatofibroma by another pathologist. On microscopic examination, vague granuloma with areas of necrosis was observed. The diagnosis was established by positive acid-fast staining, negative PCR results for M. tuberculosis complex, and positive nested PCR results for M. haemophilum.
CONCLUSION
Cutaneous lesions in immunocompromised patients with positive results in acid-fast staining and negative results for M. tuberculosis should be further assessed using skin culture and molecular techniques to identify rare, atypical mycobacterial species like M. haemophilum.
PubMed: 28043577
DOI: 10.1016/j.ijmyco.2016.09.024 -
Journal of Clinical Microbiology Feb 2019
Topics: Diagnosis, Differential; Humans; Molecular Diagnostic Techniques; Multiplex Polymerase Chain Reaction; Mycobacterium Infections; Mycobacterium haemophilum; Mycobacterium leprae; Sensitivity and Specificity
PubMed: 30463891
DOI: 10.1128/JCM.01760-18