Mycobacterium chelonae cutaneous infection in a patient with mixed connective tissue disease

Abstract

Around 50 mycobacteria species cause human disease. Immunosuppressive states predispose to non-tuberculous mycobaterium infection, such as Mycobacterium chelonae: AFB, non-tuberculous, fast growth of low virulence and uncommon as a human pathogen. It may compromise the skin and soft tissues, lungs, lymph nodes and there is also a disseminated presentation. The diagnosis involves AFB identification and culture on Agar and Lowenstein-Jensen medium base. A 41-year-old female with MCTD (LES predominance) is reported, presenting painless nodules in the right forearm. She denied local trauma. Immunosuppressed with prednisone and cyclophosphamide for 24 months. Lesion biopsy has demonstrated positive bacilloscopy (Ziehl-Neelsen stain) and M.chelonae in culture (Lowenstein-Jensen medium base), therefore clarithromycin treatment has been started (best therapy choice in the literature).

Renibacterium salmoninarum and Mycobacterium spp.: two bacterial pathogens present at low levels in wild brown trout (Salmo trutta fario) populations in Austrian rivers

“…M. marinum has been related to granulomatous lesions on the skin (finger and hand) and deep tissues (tenosynovitis, osteomyelitis, and arthritis) [27]. Furthermore, M. chelonae and M. fortuitum have been associated with nontuberculous mycobacteria in immunocompromised patient that can affect skeletal system, skin, lymph nodes and respiratory system [37,38].…”

Case of atypical cutaneousMycobacteriumchelonaeinfection in patient of systemic lupus erythematosus after cyclophosphamide therapy

“…Mycobacterium chelonae is known as a non-tuberculous environmental mycobacterium, belonging to the M. fortuitum complex, acid-fast bacilli, non-pigmented and with a fast rate of growth; it was first isolated from a sea turtle named Chelona corticata , but it is usually found in the water, soil, dust and contaminated instruments 12. There are multiple reports of this infection after trauma, surgical procedures and other procedures including acupunctures, pedicures, subcutaneous injections and pacemaker implants 12. It can cause both soft tissue and skeletal infections in healthy individuals but disseminated infection usually occurs only in immunosuppressed patients.…”

“…It can cause both soft tissue and skeletal infections in healthy individuals but disseminated infection usually occurs only in immunosuppressed patients. Clinical manifestation can vary from local abscess or ulcer formation to multi organ involvement 2. Diagnosis is confirmed by taking biopsy sample of affected tissue, Ziehl-Neelsen staining, histopathological examination, molecular biology methods, culture in appropriate mediums and RNA probes 23.…”

“…Clinical manifestation can vary from local abscess or ulcer formation to multi organ involvement 2. Diagnosis is confirmed by taking biopsy sample of affected tissue, Ziehl-Neelsen staining, histopathological examination, molecular biology methods, culture in appropriate mediums and RNA probes 23. These non-tuberculous mycobacteria are resistant to conventional anti-tuberculous drugs and there is no randomised controlled study to suggest particular therapy for these infections, however, 4–6 months of clarithromycin has been prescribed successfully previously with very few cases of resistance 2 3…”

Necrotizing osteomyelitis in a man with disseminated Mycobacterium chelonae infection

“…These infections typically are sporadic and tend to occur at sites of trauma such as penetrating injury or surgical incision [ 1 ]. Less commonly, disseminated infections may occur on a background of immunosuppression caused by medications (anti-tumor necrosis factor therapy, corticosteroids, and methotrexate) or diseases (AIDS, malignancy) [ [2] , [3] , [4] ].…”