Cutaneous <i>Mycobacterium haemophilum</i> infection in a kidney transplant recipient after acupuncture treatment

Castro-Silva, A.N.; Freire, A.O.; Grinbaum, Renato Satovschi; Abensur, Hugo; Araújo, Maria; Romão, João Egídio; Sampaio, Jorge Luiz Mello; Noronha, Irene L.

doi:10.1111/j.1399-3062.2010.00522.x

Cited by 30 publications

(14 citation statements)

References 24 publications

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“…Cho et al, 2010;W.J. Lee et al, 2010;Guevara-Patiño, et al, 2010;Castro-Silva et al, 2011;Ryu et al, 2005;Song et al, 2006;Tang et al, 2006). Among all the reported cases, only around 10% of them had systemic symptoms (Koh et al, 2010).…”

Section: Acupuncture Transmitted Mycobacterial Infectionsmentioning

confidence: 99%

Acupuncture - Clinical Practice, Particular Techniques and Special Issues

Saad¹

2011

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Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published articles. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book.

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Section: Acupuncture Transmitted Mycobacterial Infectionsmentioning

confidence: 99%

Acupuncture - Clinical Practice, Particular Techniques and Special Issues

Saad¹

2011

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“…Alternative gene targets, such as hsp65, rpoB, sodA, gyrB, dnaK, and 16S-23S rRNA internal transcribed spacer, have therefore been studied for the identification of Mycobacterium species (1,7,13,24,25,27). hsp65 gene analysis has been used for the identification of nontuberculous Mycobacterium species such as M. marinum, M. haemophilum, M. chelonae, M. fortuitum, and M. avium (3,6,9,11,14). In the present study, PCR and sequencing of hsp65 was useful in rapid diagnosis and guiding empirical antimicrobial treatment well before the culture results were available.…”

Section: Discussionmentioning

confidence: 99%

First Report of Disseminated Mycobacterium Skin Infections in Two Liver Transplant Recipients and Rapid Diagnosis by hsp65 Gene Sequencing

et al. 2011

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We present here the first report of disseminated skin Mycobacterium infections in two liver transplant recipients, in which hsp65 gene sequencing was used for rapid species identification. Both patients had hepatitis B virus-related cirrhosis and diabetes mellitus and presented with progressive generalized, nodular skin lesions. In one patient, a 50-year-old woman who had frequent contact with marine fish, an acid-fast bacillus was isolated from skin biopsy tissue after 2 months of culture. While awaiting phenotypic identification results, hsp65 gene sequencing showed that it was most closely related to that of Mycobacterium marinum with 100% nucleotide identity. The patient was treated with oral rifampin, ethambutol, and moxifloxacin. In the other patient, a 59-year-old woman, direct PCR for Mycobacterium using hsp65 gene from skin biopsy tissue was positive, with the sequence most closely related to that of M. haemophilum with 100% nucleotide identity. Based on PCR results, the patient was treated with clarithromycin, ethambutol, moxifloxacin, and amikacin. A strain of M. haemophilum was only isolated after 3 months. Skin lesions of both patients resolved after 1 year of antimycobacterial therapy. Nontuberculous Mycobacterium infections should be considered in liver transplant recipients presenting with chronic, nodular skin lesions. This report highlights the crucial role of hsp65 gene PCR and sequencing on both cultured isolates and direct clinical specimens for rapid diagnosis of slowgrowing Mycobacterium infection.Organ and tissue transplant recipients are predisposed to infections due to opportunistic pathogens, including various Mycobacterium species. While Mycobacterium tuberculosis is the most common Mycobacterium species associated with infections, nontuberculous Mycobacterium infections have been reported at an estimated incidence of 0.16 to 2.8% of transplant recipients in the United States (8). Nontuberculous Mycobacterium infections in these patients can be difficult to diagnose and often difficult to treat and are thus associated with significant morbidity and mortality.Identification of nontuberculous mycobacteria traditionally relies on isolation of the Mycobacterium and subsequent identification by phenotypic conventional biochemical tests or whole-cell fatty acid analysis. However, these methods are associated with a number of drawbacks. First, these bacteria are often slow growing, so the turnaround time for identification is long when conventional biochemical tests are used. Second, noncultivable species or isolates with ambiguous biochemical profiles are sometimes encountered, making them unidentifiable. As for whole-cell fatty acid analysis using gas chromatography, the special equipment and expertise required are not available in most routine clinical microbiology laboratories. Newer technologies, such as liquid chromatography-nuclear magnetic resonance/mass spectrometry, are being developed, which may help diagnosis of mycobacterial infections in the future (2).Molecular methods, especi...

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“…15 It seems clear that disposable acupuncture needles should be used and properly handled by qualifi ed practitioners to avoid any undesirable adverse events, and practitioners must adhere to standard infection control procedures. Further studies about the safety of acupuncture in haemodialysis patients are also needed.…”

Section: Discussionmentioning

confidence: 99%

Acupuncture for Erectile Dysfunction in a Non-Diabetic Haemodialysis Patient: A Case Report

et al. 2011

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Erectile dysfunction (ED) significantly affects the quality of life in male haemodialysis patients. This study reports the observed effects of acupuncture for ED in a non-diabetic haemodialysis patient. A 43-year-old man undergoing haemodialysis received 12 sessions of manual acupuncture over 6 weeks and was observed for 6 months after the end of treatment. Total International Index of Erectile Function Questionnaire scores of the patient were changed from 32 at baseline to 60 at post-treatment evaluation, which means there was a significant improvement of ED. All International Index of Erectile Function subscales also increased. This beneficial effect lasted up to 6 months after the end of treatment. No adverse events were observed. An interview revealed that the lowered self-esteem of the patient was restored with the improvement of ED following acupuncture. Further controlled studies are needed to determine whether acupuncture might be a feasible and useful treatment option for erectile dysfunction in haemodialysis patients.

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Cutaneous Mycobacterium haemophilum infection in a kidney transplant recipient after acupuncture treatment

Cited by 30 publications

References 24 publications

Acupuncture - Clinical Practice, Particular Techniques and Special Issues

Acupuncture - Clinical Practice, Particular Techniques and Special Issues

First Report of Disseminated Mycobacterium Skin Infections in Two Liver Transplant Recipients and Rapid Diagnosis by hsp65 Gene Sequencing

Acupuncture for Erectile Dysfunction in a Non-Diabetic Haemodialysis Patient: A Case Report

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