Ibrutinib Therapy and Mycobacterium chelonae Skin and Soft Tissue Infection

Dousa, Khalid M; Babiker, Ahmed; Aartsen, Daniel Van; Shah, Neel; Johnson, John L.; Skalweit, Marion J.

doi:10.1093/ofid/ofy168

Cited by 14 publications

(12 citation statements)

References 17 publications

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“…RGM can cause infections following invasive procedures such as subcutaneous injections of traditional medicine, excision of a sebaceous cyst, Ibrutinib therapy, skin graft, cosmetic surgery, and sclerotherapy of a varicose vein. 1,2,3,4,5 Health-care associated outbreaks is believed to be due to contaminated tap water. Environmental exposure such as gardening has also been shown to cause cutaneous RGM infections.…”

Section: Discussionmentioning

confidence: 99%

Disseminated Cutaneous Mycobacterium Fortuitum-Chelonae Complex Infection in a Young, Immunocompetent Patient: A Case Report

Rozhan¹,

Abdullah

Asha'ari³

2021

imjm

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Mycobacteria fortuitum and chelonae are a group of Rapidly Growing Mycobacteria (RGM) that can cause skin infections, most commonly in immunocompromised patients. RGM can also infect immunocompetent patients, but the disease is usually localized. Immunocompetent patients infected by RGM usually had a predisposing condition leading to the skin infection. We present a case of an immunocompetent patient with no predisposing factors, who presented with a chronic lesion on his neck that disseminated to his axilla. Culture and species identification from the skin biopsy revealed Mycobacterium fortuitum-chelonae complex. The patient was treated with a combination of surgery and multi-drug therapy. This case report highlights the rarity of cutaneous RGM infections encountered in ENT setting and the diagnostic dilemma due to the non-typical characteristics of skin lesion in RGM infections.

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Section: Discussionmentioning

confidence: 99%

Disseminated Cutaneous Mycobacterium Fortuitum-Chelonae Complex Infection in a Young, Immunocompetent Patient: A Case Report

Rozhan¹,

Abdullah

Asha'ari³

2021

imjm

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“…In addition to MAC, other NTM infections have been recorded in CLL patients, including infections with M. chelonae [10,11,12], M. marinum [13,14], M. szulgai [15], M. fortuitum [16] and M. genavense [17] (Table 2). These patients were affected mostly by disseminated cutaneous lesions ( n = 6, [10,11,12,13,14,15]) or nodular pulmonary infections ( n = 2, [13,16]). One patient presented with multifocal osteomyelitis and skin lesions [15].…”

Section: Literature Review and Discussionmentioning

confidence: 99%

Psoas Abscess Due to Mycobacterium avium in a Patient with Chronic Lymphocytic Leukemia—Case Report and Review

Diaco

Strohdach

Falkowski

et al. 2019

JCM

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Infections may constitute a serious complication in patients with chronic lymphocytic leukemia (CLL). New treatment agents including obinutuzumab and ibrutinib have improved the progression-free survival in CLL, and data suggest a similar overall infection risk and a limited risk of opportunistic infections when compared to standard chemo-immunotherapy. Nevertheless, cases of opportunistic infections including non-tuberculous mycobacterial (NTM) in CLL patients have recently been published. We present a case of a 74-year old man with extensive prior CLL treatment history, including most recently obinutuzumab. He developed an abscess of the psoas muscle and inguinal lymphadenopathy. An inguinal node biopsy specimen showed infection with Mycobacterium avium, confirmed by broad-spectrum mycobacterial PCR, M. avium-specific PCR, and mycobacterial culture. This case and our literature review suggest that physicians should be aware of opportunistic infections in patients with CLL. Diagnostic differentiation from CLL disease progression, Richter’s transformation to aggressive lymphoma, and secondary malignancy relies on histological and appropriate microbiological studies from biopsy material of affected organs. Infection prophylaxis in CLL should be considered, including vaccinations and intravenous immune globulin replacement.

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“…A case report demonstrated M. chelonae skin and soft tissue infection in a patient with chronic lymphocytic leukemia (LLC) who was using ibrutinib, an oral drug, which acts by inhibiting Bruton tyrosine kinase (BTK) for the treatment of various malignant B-cell diseases ( 173 , 174 ). After 6 months of therapy with ibrutinib, the 85-year-old man developed skin lesions on his arms and legs ( 175 ). Fiocari and colleagues ( 176 ) showed that ibrutinib promotes an M2 phenotype by modifying the function of macrophages/monocytes in the LLC.…”

Section: Role Of Autophagy In Therapeutic Approaches For Ntms and Skin Diseasesmentioning

confidence: 99%

Autophagy as a Target for Drug Development Of Skin Infection Caused by Mycobacteria

et al. 2021

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Pathogenic mycobacteria species may subvert the innate immune mechanisms and can modulate the activation of cells that cause disease in the skin. Cutaneous mycobacterial infection may present different clinical presentations and it is associated with stigma, deformity, and disability. The understanding of the immunopathogenic mechanisms related to mycobacterial infection in human skin is of pivotal importance to identify targets for new therapeutic strategies. The occurrence of reactional episodes and relapse in leprosy patients, the emergence of resistant mycobacteria strains, and the absence of effective drugs to treat mycobacterial cutaneous infection increased the interest in the development of therapies based on repurposed drugs against mycobacteria. The mechanism of action of many of these therapies evaluated is linked to the activation of autophagy. Autophagy is an evolutionary conserved lysosomal degradation pathway that has been associated with the control of the mycobacterial bacillary load. Here, we review the role of autophagy in the pathogenesis of cutaneous mycobacterial infection and discuss the perspectives of autophagy as a target for drug development and repurposing against cutaneous mycobacterial infection.

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Ibrutinib Therapy and Mycobacterium chelonae Skin and Soft Tissue Infection

Cited by 14 publications

References 17 publications

Disseminated Cutaneous Mycobacterium Fortuitum-Chelonae Complex Infection in a Young, Immunocompetent Patient: A Case Report

Disseminated Cutaneous Mycobacterium Fortuitum-Chelonae Complex Infection in a Young, Immunocompetent Patient: A Case Report

Psoas Abscess Due to Mycobacterium avium in a Patient with Chronic Lymphocytic Leukemia—Case Report and Review

Autophagy as a Target for Drug Development Of Skin Infection Caused by Mycobacteria

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