ABSTRACT
Chronic infantile neurologic cutaneous articular (CINCA) syndrome is a serious chronic systemic inflammatory disease that presents at a young age and that is characterized by skin, joint, and central nervous system disease. Skin symptoms are the first to appear, in the form of a longstanding nonpruritic urticarial rash, with exacerbations coinciding with episodes of fever, arthritis, and enlarged lymph nodes. The findings of biopsy of skin lesions are extremely variable but characterized by perivascular neutrophilic infiltrate. With the discovery of mutations in the CIAS1 gene, which encodes a protein known as cryopyrin, this entity has been classified as one of the cryopyrin-associated autoinflammatory diseases, along with familial cold urticaria and Muckle-Wells syndrome. This discovery has also made available new therapeutic options. We present the case of a boy diagnosed with CINCA syndrome who presented with an outbreak of painful skin lesions and fever. These lesions were thought to be an exacerbation of underlying lesions during an episode of fever.
Subject(s)
Arthritis/genetics , Carrier Proteins/genetics , Fever/etiology , Neurocutaneous Syndromes/diagnosis , Adrenal Cortex Hormones/therapeutic use , Adult , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Carrier Proteins/physiology , Chronic Disease , Diagnosis, Differential , Drug Therapy, Combination , Humans , Interleukin 1 Receptor Antagonist Protein/therapeutic use , Male , Meningitis, Aseptic/etiology , NLR Family, Pyrin Domain-Containing 3 Protein , Neurocutaneous Syndromes/complications , Neurocutaneous Syndromes/drug therapy , Neurocutaneous Syndromes/genetics , Neurocutaneous Syndromes/pathology , Recurrence , Sweet Syndrome/diagnosis , SyndromeABSTRACT
Atypical mycobacterial infections are increasingly important in immunosuppressed patients as well as in healthy hosts. The atypical mycobacterium that most commonly affects the skin is Mycobacterium marinum. The infection should be suspected upon the presence of ulcers, nodules or chronic plaques and a history of contact with fresh or salt water. Optimal therapy is yet to be established. We report a case of Mycobacterium marinum infection in a patient receiving immunosuppressive therapy that responded favourably to treatment with doxicycline. We review the different antibiotic regimens prescribed in the past years for the treatment of Mycobacterium marinum infection.
Subject(s)
Mycobacterium Infections, Nontuberculous/microbiology , Mycobacterium marinum/isolation & purification , Wound Infection/microbiology , Aged , Anti-Bacterial Agents/therapeutic use , Azathioprine/adverse effects , Azathioprine/therapeutic use , Doxycycline/therapeutic use , Foot Injuries/complications , Foot Injuries/microbiology , Foot Ulcer/drug therapy , Foot Ulcer/microbiology , Humans , Immunocompromised Host , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/therapeutic use , Leg Ulcer/drug therapy , Leg Ulcer/microbiology , Male , Methotrexate/adverse effects , Methotrexate/therapeutic use , Mycobacterium Infections, Nontuberculous/diagnosis , Mycobacterium Infections, Nontuberculous/drug therapy , Mycobacterium Infections, Nontuberculous/etiology , Seawater/microbiology , Spondylitis, Ankylosing/complications , Spondylitis, Ankylosing/drug therapy , Wound Infection/drug therapyABSTRACT
Las infecciones por micobacterias atípicas están adquiriendo cada vez mayor importancia en los pacientes inmunodeprimidos, así como en huéspedes sanos. El Mycobacterium marinum es la micobacteria atípica que afecta la piel con mayor frecuencia. Debe sospecharse ante la existencia de úlceras, nódulos o placas crónicas y el antecedente de un contacto con medios acuáticos. El tratamiento óptimo no está aún bien establecido. Presentamos un nuevo caso de infección por Mycobacterium marinum en un paciente que seguía tratamiento con fármacos inmunosupresores, que respondió favorablemente al tratamiento con doxiciclina y revisamos los distintos regímenes antibióticos utilizados para el tratamiento de la infección por Mycobacterium marinum en los últimos años
Atypical mycobacterial infections are increasingly important in immunosuppressed patients as well as in healthy hosts. The atypical mycobacterium that most commonly affects the skin is Mycobacterium marinum. The infection should be suspected upon the presence of ulcers, nodules or chronic plaques and a history of contact with fresh or salt water. Optimal therapy is yet to be established. We report a case of Mycobacterium marinum infection in a patient receiving immunosuppressive therapy that responded favourably to treatment with doxicycline. We review the different antibiotic regimens prescribed in the past years for the treatment of Mycobacterium marinum infection
