Mycobacterium abscessus skin infection after tattooing - Case report

AbstractMycobacterium abscessus is a rapidly growing mycobacterium that has been affecting people undergoing invasive procedures, such as videosurgery and mesotherapy. This bacterium has global distribution, being found in numerous niches. The frequency of published reports of infection by rapidly growing mycobacteria associated with tattooing procedures has increased in recent years. However, in Brazil there were no case reports of M. abscessus after tattooing in the literature until now. In this paper, we describe the case of a patient with a nine-month history of lesion on a tattoo site. The diagnosis of infection with Mycobacterium abscessus was established by correlation between dermatological and histopathological aspects, culture and molecular biology techniques. The patient had significant improvement of symptoms with the use of clarithromycin monotherapy.

Infección Cutánea por Mycobacterium chelonae / Cutaneous infection by Micobacterium chelonae

Mycobacterium chelonae es una micobacteria atípica, de rápido crecimiento, ampliamente distribuida en la naturaleza. Germen oportunista del humano y causante de infecciones de diversa gravedad. Suele ser resistente a los métodos habituales de desinfección y esterilización. Es fundamentalpara su diagnóstico y tratamiento el aislamiento del mismo y la obtención del antibiograma, ya que presenta resistencia a diferentes antibióticos. Se presentan dos casos clínicos de infección cutánea por Mycobacterium chelonae. El primero, un paciente inmunocompetente, con aislamiento de la micobacteria por punción-aspiración de las lesiones; tratado con antibióticos según antibiograma, con curación de las mismas. El segundo, una paciente inmunocomprometida no HIV, quien fue tratada con múltiples esquemas antibióticos, criocirugía, termoterapia y resección quirúrgica de las lesiones, con respuesta parcial. El presente artículo intenta actualizar conceptos sobre esta micobacteria y sus diferentes manifestaciones clínicas según el estado inmune del paciente que infecta.

Delayed post-operative wound infections due to non-tuberculous Mycobacterium.

BACKGROUND & OBJECTIVE: The non-tuberculous mycobacteria (NTM) have emerged as important opportunistic pathogens of human beings in the recent years. The NTM are rapid growing mycobacteria (RGM), which include Mycobacterium fortuitum and M. chelonae and grouped as M. fortuitum-chelonae complex. Though there are reports on isolation of NTM from various parts of India, information on its occurrence in northeastern India is lacking. We therefore undertook this preliminary investigation to report on the occurrence of NTM-associated with non-healing postoperative wound infections that did not respond to antibiotics used for pyogenic infections and having sterile routine aerobic cultures in patients from northeastern part of India. METHODS: Pus/discharge from 25 patients with delayed onset of post-operative wound infections not responding to antibiotics used for pyogenic infections were collected and examined for isolation and identification of the causative agents. RESULTS: Of the 25 pus/discharge specimens examined, 20 revealed growth of non-tuberculous Mycobacterium spp. All the isolates were identified as M. fortuitum-chelonae complex. Of these only 10 samples revealed acid-fast bacilli (AFB) on direct examination of Ziehl-Neelsen stained smears from the specimens. All cases where direct smear was positive for AFB were also positive for Mycobacterium culture. INTERPRETATION & CONCLUSION: The results of the present study indicated that non-tuberculous mycobacterial post-operative wound infection was fairly common in northeastern India. Thus, mycobacterial infections should be considered in wounds that show delayed healing and do not respond to antibiotics used for acute pyogenic infections. Further, 80 per cent of the specimens yielded the growth of AFB in cultures as against only 40 per cent positive in the ZN stained direct smears. This indicates the possibility of missing a mycobacterial wound infection if only direct smears are taken for diagnosis.

Linfadenitis causada por Mycobacterium malmoense en paciente infectado con virus de inmunodeficiencia humana / Lymphadenitis caused by Mycobacterium malmoense in HIV infected patient

Se reporta el primer caso cubano de micobacteriosis causada por Mycobacterium malmoense en un paciente infectado por el virus de inmunodeficiencia humana (VIH), el cual presentaba adenopatías ulcerativas submandibulares. A partir de las muestras tomadas de las lesiones ulceradas, se aisló una cepa de micobacteria no pigmentada de crecimiento lento, perteneciente al grupo I de Runyon, posteriormente fue clasificada por test bioquímico y por el análisis de las fracciones de ácidos micólicos, como Mycobacterium malmoense.

Interface keratitis due to Mycobacterium fortuitum following laser in situ keratomileusis.

A case of unilateral interface keratitis due to Mycobacterium fortuitum following simultaneous bilateral LASIK procedure for low myopia is reported. Excimer phototherapeutic keratectomy was performed to the stromal bed to reduce the infective load. Intensive topical therapy with topical amikacin and ciprofloxacin resulted in resolution of the keratitis.

Atypical mycobcterial injection abscess.

Other than suppurative organisms, atypical mycobacteria are also known to cause injection abscesses following vaccinations, injections, tattooing and even after implants. Though the usage of disposable needles is practised universally, sporadic cases do occur. The disease entity should be considered, while dealing with injection abscesses, to institute specific therapy. Acid-fast bacilli should be looked for in the pus and mycobacterial culture of the material from injection abscesses should be done for a definitive diagnosis.

Port-site infection with Mycobacterium chelonei following laparoscopic appendicectomy.

We report a 14-year-old girl who developed port-site infection with Mycobacterium chelonei following laparoscopic appendicectomy. She was treated with local exploration and excision of sinuses that developed at the site, followed by antibacterial agents for six months. She has had no recurrence of infection at two years.

Mycobacterium fortuitum endocarditis and meningitis after balloon mitral valvotomy.

Mycobacteria rarely cause endocardial infections. We describe the clinical course of a patient who developed endocarditis, and meningitis with Mycobacterium fortuitum following balloon mitral valvotomy. The patient was treated with amikacin and clarithromycin but did not respond. She developed haemolytic anaemia as the terminal event.

Granuloma de los acuarios: presentación de tres casos / Aquarium granuloma: presentation of three cases

El granuloma de los acuarios es una afección crónica causada por una micobacteria atípica de crecimiento lento, identificada como Mycobacterium marinum. Este germen cuyo hábitat natural es el agua, sólo es patógeno para la piel escoriada. Se presenta el cuadro clínico e histopatológico característico de tres casos evaluados en nuestro medio, con la identificación microbiológica del germen, y respuesta favorable al tratamiento establecido

Micobacteriose Atípica Pós Transplante Alogênico de Medula Ossea / Mycobacteriosis atypical transplant from

Os autores apresentam um raro caso de micobacteriose atípica bem como complicaçöes imunológicas, em um paciente portador de LMC fase crônica submetido a um TMO alogênico com célula-tronco periférica de doador HLA idêntico. Säo discutidas as características clínicas do paciente ao diagnóstico, a terapêutica instituída e as possíveis causas de óbito

Mycobacterium chelonae y Mycobacterium abscessus: patógenos emergentes / Mycobacterium chelonae y Mycobacterium abscessus: emergents pathogens

Mycobacterium chelonae es el nombre correcto de la micobacteria aislada en 1903 de los pulmones enfermos de una tortuga marina. En una especie distinta de Mycobacterium fortuitum, aislado de ranas en 1905, y de Mycobacterium abscessus, considerado actualmente como una subespecie de M. chelonae. Estas tres epecies son las únicas patógenas para el hombre dentro del grupo de micobacterias ambientales o atípicas, de crecimiento rápido, las cuales se caracterizan por formar colonias en cultivo en menos de siete días. Son agetes etiológicos de nódulos y abscesos cutáneos, localizados y diseminados, de lesiones postoperatorias, usualmente en la cicatriz quirúrgica, de lesiones pulmonares y de linfadenitis granulomatosa, de osteomielitis y de queratitis entre otras. Las lesiones cutáneas y de los tejidos blandos son las más frecuentes y resultan generalmente de la inoculación traumática de esta micobacteria. Histológicamente, los nódulos y abscesos muestran un proceso inflamatorio, supurativo y granulomatoso, mixto, en el que en la cuarta parte de los casos pueden demostrarse conglomerados de bacilos ácidos alcohol resistentes, que tienden a estar situados en una vacuola en el centro del absceso. En colombia, se han descrito tres brotes de abscesos subcutáneos producidos por bacterias ambientales, secundarios a la aplicación de inyecciones contaminadas con el germen causal: en 1981, en Bucaramanga, luego de la aplicación de la vacuna contra la fiebre amarilla, en 50 personas, la mayoría niños; en 1989, en Medellín, por la inyección subcutánea de alergenos, en 13 personas; y, en 1993, en varias ciudades de la costa atlántica, luego de aplicaciones subcutáneas de xilocaína, como tratamiento bionergético, en 297 pacientes. Existen otros informes aislados de casos post-traumáticos

Micobacterosis diseminada con localización cutánea por Mycobacterium bovis en un paciente HIV positivo / Disseminated Mycobacteriosis localized to the skin due to M bovis in a HIV (+) patient

Presentamos el caso de un paciente del sexo masculino, de 24 años de edad, adicto endovenoso, HIV positivo, quién desarrolló una micobacteriosis diseminada con localización cutánea por Mycobacterium bovis. Se comentan aspectos clínicos e incidencia de las micobacteriosis tuberculosas y no tuberculosas, la poca frecuencia de las provocadas por Mycobacterium bovis y la buena respuesta al tratamiento específico en nuestro paciente a pesar de su importante inmunosupresión

Neumonia por micoplasma / Mycoplasma pneumonia

Este peculiar proceso, por las características del agente etiológico y por la compleja expresividad clínica que presenta, es motivo fundamental del trabajo, Poner en conocimiento la presencia de la enfermedad en el medio. Determinar la incidencia de neumonía por mycoplasma, durante los años 1992-1994. Asimismo, determinar las principales manifestaciones clínicas y complicaciones, sobre todo las extrapulmonares. Compara esquemas terapéuticos, utilizando tiempo y dosis de los mismos. Definir pautas de diagnóstico y finalmente normar el manejo terapéutico a seguir.

Differential identification of pathogenic mycobacteria isolated from patients clinically diagnosed as pulmonary tuberculosis

By staining sputum samples from 121 patients diagnosed clinically to have pulmonary tuberculosis, before and after treating, sputum with digestion decontamination procedure [concentration], acid fast bacilli were detected in 10.7% and 22.36% of the cases respectively with statistically significant difference. By culture on L.J. agar, 38 strains [31.4%] were isolated. Comparing the results of staining, direct smear before and after concentration with that of culture, it was found that Z. N. staining of sputum after concentration is more sensitive and can be relied upon in diagnosing tuberculous infection. Applying the differential identification biochemical reactions, the 38 strains were: 32 [84.2%] Mycobacterium tuberculosis, 2 [5.3%] M. avium, one [2.6%] M. Kansasii, one [2.6%] M. zenopi and 2 strains that could not be identified. All the strains were sensitive to rifampin, 28.9% were resistant to isoniazid, 13.1% were resistant to ethambutol, 7. 9% were resistant to streptomycin and 5.3 were resistant to kanamycin

Infecçäo por "mycobacterium kansasii" em hemofílico com SIDA / Infection by \"mycobacterium kansasii\" in hemophilic and AIDS patient

O Mycobacterium kansasii é causa rara de doença pulmonar em pacientes com SIDA. Ocorre em somente 0,2 por cento dos casos da sindrome. Os autores apresentam um caso de doença pulmonar causada pelo M. Kansasii, com apresentaçao radiológica nao-habitual, em paciente hemofílico com Sida.

Changing patterns of infectious keratitis: overview of clinical and histopathologic features of keratitis due to acanthamoeba or atypical mycobacteria, and of infectious crystalline keratopathy.

Acanthamoeba keratitis, infectious crystalline keratopathy and atypical mycobacterial keratitis have recently emerged as important types of infectious keratitis. These corneal infections have been associated with contact lens wear and with corneal surgical procedures such as radial keratotomy and penetrating keratoplasty, and the clinical setting of each of these infections is important in alerting the clinician to the possible diagnosis. There have been improvements in rapid diagnostic techniques for such infections in the last several years. Treatment has also improved, but remains a difficult problem, especially for Acanthamoeba. An overview of recent developments in the clinical and histopathologic methods for diagnosis and treatment options of these three corneal infections is provided.

Reaçäo tuberculínica e as reaçöes cruzadas com a vacinaçäo BCG e com infecçöes por micobactérias näo-tuberculosas / Tuberculin skin test and cross reaction with BCG vaccine and other nontuberculosis micobacterial infections

A utilidade do teste tuberculínico tem sido contestada em nosso país porque a infecçäo por bacilos näo-Mycobacterium tuberculosis e principalmente o BCG determinaram reaçäo cruzada com o PPD. Considerando que a prevalência de bacilos näo-M. tuberculosis no país é baixa e que as reaçöes induzidas por eles e pelo BCG säo em geral de menor intensidade e mais fugazes quando comparadas com as causas pelo M. tuberculosis, conclui-se que o teste tuberculínico com PPD 2U continuará a ser de grande utilidade, näo se justificando seu abandono em becegeizados

Micobacteriosis por M. marinum: comunicación del primer caso con lesiones esporotricoides en México / Mycobacteriosis for M. marinum: report of a case with sporotrichoid lesions in Mexico

Se hace una breve revisión de la literatura y se presenta el caso de una mujer de 32 años con lesiones esporotricoides gomosas en mano y antebrazo izquierdo. La dermatosis se presentó después de un traumatismo con una pecera doméstica. Se cultivó M. marinum y se trató con rifampicina, amikacina, isoniacida y doxiciclina, con éxito.

Ocorrência de micobactérias atípicas em ambientes aquáticos / Occurrence of atypical mycobacteria in aquatic environment

Micobactérias atípicas foram isoladas em 27% das 128 anostras de água coletadas a partir de torneiras (26,9%), bebedouros (17,6%), piscinas (16,6%), reservatórios (28,5%), mananciais (21,4%), águas de contato animal (58,5%), lagoas salgads (27,2%) e mar (17,6%). A técnica de isolamento utilizou a concentraçäo por filtraçäo em membrana e ácido sulfúrico a 6% como agente depurante. Entre as 63 estirpes identificadas, a espécie mais freqüente foi o M. gordonae (17,4%). Entretanto, foram encontradas micobactérias potencialmente patogênicas pertencentes ao complexo MAIS (17,4%) e M. fortuitum (12,7%), além de duas estirpes de M xenopi e uma de M chelonei