[Mycobacterium malmoense cutaneous infection in an immunocompetent patient]. / Infection cutanée à Mycobacterium malmoense chez une malade immunocompétente.

BACKGROUND: Mycobacterium malmoense is a mycobacterium rarely described as a human pathogen. We report the first case of cutaneous infection in an immunocompetent patient. CASE REPORT: A 75-year-old woman presented with a cutaneous nodula on the back of her left hand. Histology of the node biopsy showed non caseating granuloma with giant and epithelioid cells. Acid-fast bacilli were isolated at direct smear and after culture. Mycobacterium malmoense was identified. The lesion has healed after surgery. DISCUSSION: Mycobacterium malmoense is an environmental mycobacterium isolated from soil and water. Typically, most patients with Mycobacterium malmoense infections are old people with previously lung disease. A few cervical lymphadenitis in children and rare cases of tenosynovitis of the hand have been reported. Disseminated infections with cutaneous lesions have been exceptionally described in immunocompromised patients. Mycobacterium malmoense is slow growing and its identification is hard, sometimes requiring molecular analysis. Probably it's the reason why we present the first description of a cutaneous infection in an immunocompetent patient. This case indicates that Mycobacterium malmoense is also a cutaneous pathogen.

[Antibacterian activity modifications of serum isoniazid when using it with rifampicin (author's transl)]. / Modifications du pouvoir antibactérien de l'isoniazide sérique en association avec la rifampicine.

When dosing isoniazid in patients' serum after ingestion, the authors find a difference in the isoniazid levels when isoniazid is used alone, then, when isoniazid is used simultaneously with rifampicin. The level decreases or increases according to the inactivation index. They analyse the therapeutic consequences which can result from it. They infer, from the practical point of view, the necessity of : dosing isoniazid after having ingested it simultaneously with rifampicin and not alone when the efficient therapeutic dose is to be determined ; testing serum levels during antituberculous therapy for an eventual readjustment.