Diagnostics of tuberculosis and differentiation of nonspecific tuberculin reactions in animals

Abstract Tuberculosis is a serious disease of humans and animals, caused by bacteria of the Mycobacterium genus. This leads to complications in the life of the sick person, and subsequently to death. The cattle, who have been diagnosed with this bacterium, are usually sent to the slaughter, with the result that their livestock is reduced. Mycobacteriosis is also a disease, after determining which cattle are most often sent to slaughter. Such a reduction in livestock numbers has a negative effect on the economy. Of the 300 samples from the animals, 25 cultures of atypical bacteria responding to tuberculin were isolated. A series of tests - intravenous tuberculin test, ophthalmic test, palpebral test, "ZhAT" test, showed that most of the tuberculosis changes in cattle were found in regional lymph nodes more often than in internal organs. In healthy for tuberculosis cows, at the age of 4-9 years, seasonal nonspecific sensitivity to tuberculin is observed. Implementation of the developed express method of glutaraldehyde test on farms in healthy tuberculosis will speed up the diagnosis of tuberculosis and mycobacteriosis in animals that reacted to tuberculin and will exclude short-term nonspecific sensitization of their organism to tuberculin. The introduction of this methodology can be used to diagnose and clearly differentiate the diagnoses of "tuberculosis" and "mycobacteriosis" in cattle. This will cure part of the livestock and reduce the amount of slaughter.

A Case of Mycobacterium chelonae Infection at the Site of Acupuncture / 대한피부과학회지

No abstract available.

A Case of Disseminated Skin and Soft Tissue Infection due to Mycobacterium abscessus with Metastatic Breast Cancer / 감염과화학요법

Mycobacterium abscessus is a rapidly growing species of environmental mycobacteria commonly found in soil, dust, and water throughout the world. In immunocompetent patients, M. abscessus usually causes localized infection of skin and soft tissue in association with a traumatic or surgical wound. Although rare, it may cause disseminated systemic infection in patients with HIV, diabetes, or medically induced immunosuppression. Here we report a case of a 53-year-old female patient with disseminated skin and soft tissue infection due to M. abscessus who presented with multiple skin lesions on the trunk, back and four extremities. The patient had undergone salvage chemotherapy, modified radical mastectomy, and palliative chemotherapy for metastatic breast cancer. Granulomatous inflammation and acid-fast bacilli were found on skin biopsy. M. abscessus was identified via mycobacterial culture and PCR-restriction fragment length polymorphism analysis. The patient responded well to clarithromycin, cefoxitin and amikacin therapy, and was subsequently discharged on oral antimicrobial therapy. Non-tuberculous mycobacterial (NTM) infection is a rare cause of skin and soft tissue infection, and a very high index of suspicion is required to initiate an evaluation for NTM. In metastatic cancer patients with multiple skin lesions, skin infection due to NTM must be differentiated not only from cutaneous metastasis but also from bacterial or fungal infection.

Frecuencia de micobacterias ambientales en Chile en el año 2008 / Frequency of environmental mycobacterium in Chile: 2008

Objective: To know the frequency of environmental mycobacterium isolations in Chile in the year 2008. Methods: 600 AFB (acid fast bacilli) positive cultures from 22 laboratories of Tuberculosis Bacteriology of the different Network Health Services that constitute the Tuberculosis Control Program of the country were studied, during four months at 2008. 545 (90.8 percent) were pulmonary and 55 (9.2 percent) extra pulmonary. Acid fast bacilli smears were confirmed by Ziehl Neelsen and identification of mycobacteria species or complex were identified by traditional tests according to Runyon classification and biochemical tests, genetic probes and pattern analysis restriction (PRA). Results: 585 cultures were appropriated for inclusion in the study. In 91.3 percent (n = 534) of the cases Mycobacterium tuberculosis was isolated while 0.3 percent was Mycobacterium bovis subspecie BCG (n = 3) and 8.4 percent (n = 48) corresponded to environmental mycobacterium. Of the latter, Mycobacterium kansasii (2.6 percent), Mycobacterium avium-intracellulare (1.5 percent) and Mycobacterium chelonae (1.0 percent) were the most commonly isolated. Conclusion: According to the figures of this study and comparing them with studies of previous years (1988 and 1998) it is concluded that the number of environmental mycobacterium isolated has been relatively constant during the last decade, as well as the species, more commonly isolated.

Objetivos: Conocer la frecuencia de aislamientos de micobacterias ambientales en Chile en el año 2008. Material y Métodos: Se recibieron 600 cultivos desde 22 laboratorios de Bacteriología de la Tuberculosis de los distintos Servicios de Salud de la red que comprende el Programa de Control de la Tuberculosis del país, durante un período de cuatro meses del año 2008. Quinientos cuarenta y cinco (90,8 por ciento) correspondieron a localización pulmonar y 55 (9,2 por ciento) a extrapulmonar. Se confirmó la alcohol-ácido resistencia por tinción de Ziehl Neelsen y para la identificación de especies o complejos micobacterianos se utilizaron pruebas tradicionales y bioquímicas de acuerdo al criterio de clasificación de Runyon, sondas genéticas y análisis de patrones de restricción (PRA). Resultados: De los 600 cultivos recibidos, 585fueron aptos para ser incluidos en el estudio. De éstos, en el 91,3 por ciento (n = 534) de los casos se aisló Mycobacterium tuberculosis, en un 0,3 por ciento Mycobacterium bovis subespecie BCG (n = 3) y un 8,4 por ciento (n = 48) correspondió a micobacterias ambientales. De estas últimas, Mycobacterium kansasii (2,6 por ciento), Mycobacterium avium-intracellulare (1,5 por ciento) y Mycobacterium chelonae (1,0 por ciento) fueron las más comúnmente aisladas. Conclusiones: De acuerdo a las cifras obtenidas en este estudio y comparadas con estudios de años anteriores (1988 y 1998) se concluye que el número de aislamientos de micobacterias ambientales permaneció relativamente constante esta última década, como también las especies más comúnmente aisladas.

Mybacterium chelonae Infection Occurring at the Site of Bee Sting Therapy / 대한피부과학회지

Mycobacterium chelonae is a rapidly growing atypical mycobacterium found in soil and water. In a healthy person, it causes cutaneous infection after an invasive procedure or surgery. Herein, we present a case of a 52-year-old man with multiple erythematous plaques and nodules on the back and left arm, and these occurred at the site of bee sting therapy by a herbal medical doctor. The histologic findings showed a granulomatous infiltration composed of numerous neutrophils, lymphocytes, eosinophils, histiocytes and multinucleated giant cells. Acid fast bacilli were detected by Ziehl-Neelsen stain and Mycobacterium chelonae infection was confirmed by an INNO-LiPA mycobacteria kit. The patient was treated with 1 g of clarithromycin and 200 mg of doxycycline for 6 months and his condition improved considerably.

Soft Tissue Infection with Mycobacterium abscessus on the Chin of a Healthy Child: A Case Report

PURPOSE: Mycobacterium abscessus belongs to the group of rapid-growing atypical mycobacterium. The organism is ubiquitous and is found in soil, dust, and water. Although it rarely causes disease in humans, Mycobacterium abscessus has been associated with soft tissue infection. To the best of our knowledge, this is the first case report of facial soft tissue Mycobacterium abscessus infection in a healthy child in Korea. METHODS: A 12-year-old girl presented with an erythematous skin lesion with serous discharge on her chin, which had been present for 3 weeks. On her history, she had a laceration wound on her chin at public bath and the lesion was repaired at emergency department immediately. Although conventional soft tissue infecton treatment, her lesion remains unhealed state and had serous discharge for 2 months. Moreover, we found a 1cm sized nodular mass on her chin. Therefore we performed excision operation and referred the specimen to the laboratory for microbial and histopathologic study. RESULTS: Pathology report confirmed the mass was enlarged lymph node with chronic necrotizing granulomatous inflammation with central microabscess. Non-Tuberculous mycobacterium identification test through tissue specimen resulted Mycobacterium abscessus. We prescribed clarithromycin for three weeks by oral administration as well as performed wound debridement and mass excision via previous wound. This way, her lesion appeared to be complete healing with minimal scarring. There were no evidence of inflammation sign or palpable mass. CONCLUSION: Although the prevalence is rare, Mycobacterium abscessus infections of soft tissue should be considered even in a healthy child with a lesion caused by trauma or which fails to respond to conventional treatment.

Mycobacteriosis in wild birds: the potential risk of disseminating a little-known infectious disease / Micobacteriosis en aves silvestres: riesgo potencial de diseminación de una infección poco conocida en el mundo

Avian mycobacteriosis is important for animal and human health; wild birds play an important role in mycobacterial species' ecology and movement. This review was aimed at reporting the role of birds in the spread of avian mycobacteriosis in human and animal populations at risk and thus a systematic review was made of PubMed, Science Direct, Scielo and Scirus databases. Mycobacteria are classified into the Mycobacterium tuberculosis complex and non-tuberculous mycobacteria; the Mycobacterium avium complex represents the most important part of the latter because it is primarily responsible for mycobacterial infection in wild birds and is a potential pathogen for mammals, especially for immunocompromised patients. The clinical signs in birds are variable as it is a chronic and debilitating disease, involving emaciated carcasses, white nodules in different organs and microscopically it presents granulomatosous multifocal inflammation. Diagnosis begins by suspicion based on clinical signs and finishes with microbiological confirmation. New diagnostic techniques include testing with DNA-RNA probes. No effective treatment is currently available and chemoprophylaxis on suspicion of infection is not recommended at the start; these factors increase the potential risk of mycobacteriosis becoming one of the most frequently documented zoonotic diseases which is difficult to treat in birds and humans. Recent concern regarding mycobacterial infection lies in the increased frequency of these opportunistic infections occurring in immunocompromised individuals and these infections' potential impact on bird conservation, this being increased by greater contact between humans and wild and captive birds.

La micobacteriosis aviar es de importancia para la salud animal y humana. El objetivo de esta revisión fue reportar el papel de las aves en la diseminación de la micobacteriosis aviar en poblaciones vulnerables. Se realizó una revisión sistemática en las bases de datos PubMed, Science Direct, Scielo and Scirus. Las aves silvestres juegan un papel importante en la ecología y movimiento de micobacterias. Estas se clasifican en el Complejo Mycobacterium tuberculosis y las micobacterias no tuberculosas, dentro de este último grupo se destaca el Complejo Mycobacterium avium , principal responsable de micobacteriosis en aves silvestres y patógeno potencial para los mamíferos principalmente pacientes inmunosuprimidos. Los signos clínicos son variables, siendo una enfermedad debilitante y crónica, e involucra carcasas emaciadas, nódulos blanquecinos en diferentes órganos, microscópicamente presenta inflamaciones granulomatosas multifocales. El diagnóstico inicia por la sospecha basada en los síntomas clínicos y termina con la confirmación microbiológica. Adicionalmente, las nuevas técnicas diagnósticas incluyen pruebas con sondas de ADN-ARN. Actualmente, no existe un tratamiento efectivo y no se recomienda iniciar quimioprofilaxis; estos factores incrementan el riesgo potencial para convertir la micobacteriosis aviar en una enfermedad zoonótica más frecuente de lo documentado y de difícil tratamiento en aves y humanos. La reciente preocupación de las infecciones micobacterianas, radica en el aumento de la frecuencia de estas infecciones oportunistas en personas inmunocomprometidas y el impacto potencial de estas infecciones sobre la conservación de las especies de aves, favorecido por el mayor contacto entre humanos y aves tanto silvestres como cautivas.

M. chelonae Soft Tissue Infection Spreading to Osteomyelitis

A previously healthy, 54-year-old woman presented with Mycobacterium chelonae soft tissue infection and osteomyelitis of her left lower leg. The infection had started from soft tissue emerging at the medial aspect of the distal femur and had spread through the bone because of delayed diagnosis. The largely indolent, 8-month course to diagnosis was attributable to unremarkable clinical manifestations combined with a low index of suspicion such as immunocompetent patient and/or inadequate finding of acid-fast bacilli in a lesion smear, characteristic histopathological features, and culture techniques. Soft tissue infection and osteomyelitis were successfully treated without surgical intervention and with a 6-month course of chemotherapy.

Identification of Atypical Mycobacterium with the Polymerase Chain Reaction in Tuberculous Lymphadenitis

Tuberculous lymphadenitis is easily mistaken for an infection by only mycobacterium tuberculosis. However, many cases reveal atypical mycobacterium. Treatment of atypical mycobacterium differs from that of M. tuberculosis and M. bovis. Usual anti-tuberculous medication is the response to M. tuberculosis and M. bovis, but not to atypical mycobacterium. Excision and antibiotic therapy is the known treatment of choice for atypical mycobacterium. We used the polymerase chain reaction(PCR) for differential diagnosis of tuberculosis from lymphadenitis, and by using PCR we were able to differentiate the infecting organism as typical or atypical mycobacterium. We excised 50 case of cervical lymphadenitis, and PCR was done with Primer I(IS6110), which is specific for M. tuberculosis and M. bovis, and with Primer II(65 KDa Ag), which covers all mycobacterium species. The results obtained by PCR were compared with the pathologic results(control): sensitivity 81.8%, specificity 88.9%, false positive ratio 11.1%, false negative ratio 18.2%, typical mycobacterium 45.5%, and atypical mycobacterium 45.5%. These findings suggest that PCR is a good diagnostic tool for the early detection of tuberculous lymphadenitis and for differentiation of mycobacteria in cervical lymphadenitis.