Cutaneous non‐tuberculous mycobacterial infections

Abstract

Mycobacteria cause a range of diseases in both immunocompetent and immunosuppressed individuals and may affect many different organs. The most noticeable recent change in patterns of cutaneous mycobacterial infection refers to the increase in non-tuberculous mycobacterial (NTM) infections. This review focuses on the clinical manifestations, diagnosis, and treatment of cutaneous NTM infections. The MEDLINE, PubMed, and Cochrane Library databases were searched using the keywords "non-tuberculous mycobacteria," "atypical mycobacteria," and "mycobacteria other than tubercle bacilli". Publications on cutaneous NTM infections written in English were included in this review. Literature published by the World Health Organization was examined for further material. References in review articles were screened for other studies not already identified. The clinical features, diagnosis, and treatment of NTM infections were reviewed. Cutaneous mycobacterial disease may take many guises and may appear benign in nature. Chronic cutaneous lesions at the sites of trauma or surgical procedures, especially those that fail to respond to standard antibiotic therapy, should prompt the consideration of mycobacterial disease. The lack of rapid techniques for the identification of pathogens makes diagnosis challenging. The lack of randomized controlled trials on the efficacy of antimicrobial agents means that empiric therapy may fail, necessitate prolonged combinations of antibiotics, and increase the probability of side effects and diminished compliance.

Clinical and histopathological features of cutaneous nontuberculous mycobacterial infection: a review of 13 cases

“…We reviewed 13 cases of cutaneous NTM infection encountered in our institution. In our review, M. marinum was the most common organism isolated, followed by rapidly growing mycobacteria (which includes M. abscessus , M. chelonae and M. fortuitum ) . This is similar to other case series of cutaneous NTM infection …”

“…They are environmental saprophytes and have low pathogenicity in humans. Cutaneous NTM infections are rare; however, the incidence has increased in recent decades due to better detection methods and widespread use of immunosuppressive therapies …”

“…Mycobacterium marinum and Mycobacterium ulcerans cause distinct clinical entities, known as swimming pool granuloma and Buruli or Bairnsdale ulcer, respectively . Otherwise the clinical appearances of cutaneous NTM infections are not pathognomonic, and the organisms are often slow and difficult to culture, making it difficult to establish a timely diagnosis.…”

Genomic characterization of Nontuberculous Mycobacteria

“…Among NTM species, an increasing number of strains have been deemed responsible, in the last decades, of severe and treatment-resistant diseases910111213. NTMs are present in the environment, in particular in water and soil14, and can occasionally infect humans or animals causing a range of pathological conditions including pulmonary, skin, bone, joint, and disseminated diseases in the presence of various predisposing conditions (primarily chronic diseases and immunosuppression)15161718. Although several NTM species are now recognized as a major infective threat19, their in-depth genomic investigation has not been carried out systematically.…”

Atypical Mycobacterial Infection after Abdominoplasty Overseas: A Case Report and Literature Review

“…Gram stains and regular cultures usually do not yield any results and specific stains and cultures for mycobacteria are required [6, 9, 10]. RGM are specially sensitive to decontamination and discoloration procedures; therefore, it is difficult to rule out RGM infection with a negative smear [8].…”