Atypical mycobacteria are saprophytic organisms not transmitted from person to
person, which affect mainly immunosuppressed but also immunocompetent individuals. We
present a case of atypical mycobacteriosis after a vascular procedure, with
widespread cutaneous lesions associated with polyarthralgia. Mycobacterium chelonae
was identified by the polymerase chain reaction (PCR) method. The patient showed
improvement after treatment with three antibiotics. Mycobacterium chelonae causes
skin lesions after invasive procedures. The clinical form depends on the immune state
of the host and on the entry points. The diagnosis is based essentially on culture
and the mycobacteria is identified by PCR. We highlight the importance of
investigating atypical mycobacteriosis when faced with granulomatous lesions
associated with a history of invasive procedures.
This study compares patients with and without non-viral microbial keratitis in relation to sociodemographic variables, clinical aspects, and involved causative agent. Clinical aspects, etiology and therapeutic procedures were assessed in patients with and without keratitis that were diagnosed in an Eye Care Center in Campo Grande, MS, Brazil. Patients were divided into two groups: (a) cases: 64 patients with non-viral microbial keratitis diagnosed at biomicroscopy; and (b) controls: 47 patients with other eye disorders that were not keratitis. Labor activity related to agriculture, cattle raising, and contact lens use were all linked to keratitis occurrence (p<0.005). In patients with keratitis, the most common symptoms were pain and photophobia, and the most frequently used medicines were fourth-generation fluoroquinolones (34.4%), amphotericin B (31.3%), and natamycin (28.1%). Microbial keratitis evolved to corneal perforation in 15.6% of cases; transplant was indicated in 10.9% of cases. Regarding the etiology of this condition, 23 (42.2%) keratitis cases were caused by bacteria (Pseudomonas aeruginosa, 12.5%), 17 (39.1%) by fungi (Fusarium spp., 14.1% and Aspergillus spp., 4.7%), and 4 (6.3%) by Acanthamoeba. Patients with keratitis present with a poorer prognosis. Rapid identification of the etiologic agent is indispensable and depends on appropriate ophthalmological collection and microbiological techniques.
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