Outbreak of Mycobacterium haemophilum Infections after Permanent Makeup of the Eyebrows

Giulieri, Stefano; Morisod, Benoît; Edney, Timothy; Ödman, Micaela; Genné, Daniel; Malinverni, Raffaele; Hammann, Catherine; Musumeci, Enrico; Voide, Cathy; Greub, Gilbert; Masserey, Éric; Billé, Jacques; Cavassini, Matthias; Jaton, Katia

doi:10.1093/cid/ciq191

Cited by 54 publications

(49 citation statements)

References 12 publications

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“…This approach was applied in several reported M. haemophilum cases (52,70,114). The method can be performed by using a number of gene fragments (see "Molecular Identification Methods" above).…”

Section: Direct Detection Methodsmentioning

confidence: 99%

“…Treatment in these patients consisted of clarithromycin, rifabutin, and ethambutol or ciprofloxacin. In a recent case series of 12 patients with eyebrow lesions and cervicofacial lymphadenitis, surgical excision was curative, and in the majority of the cases antibiotics were not successful (52).…”

Section: Immunocompetent Patientsmentioning

confidence: 99%

“…An outbreak of 12 cases of M. haemophilum skin infection with lymphadenitis after permanent makeup on the eyebrows was described recently (52). The ink used by the tattoo artist was found to be contaminated with M. haemophilum.…”

Section: Immunocompetent Patients Adult Infectionsmentioning

confidence: 99%

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Clinical Manifestations, Diagnosis, and Treatment of Mycobacterium haemophilum Infections

et al. 2011

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SUMMARY Mycobacterium haemophilum is a slowly growing acid-fast bacillus (AFB) belonging to the group of nontuberculous mycobacteria (NTM) frequently found in environmental habitats, which can colonize and occasionally infect humans and animals. Several findings suggest that water reservoirs are a likely source of M. haemophilum infections. M. haemophilum causes mainly ulcerating skin infections and arthritis in persons who are severely immunocompromised. Disseminated and pulmonary infections occasionally occur. The second at-risk group is otherwise healthy children, who typically develop cervical and perihilar lymphadenitis. A full diagnostic regimen for the optimal detection of M. haemophilum includes acid-fast staining, culturing at two temperatures with iron-supplemented media, and molecular detection. The most preferable molecular assay is a real-time PCR targeting an M. haemophilum -specific internal transcribed spacer (ITS), but another approach is the application of a generic PCR for a mycobacterium-specific fragment with subsequent sequencing to identify M. haemophilum . No standard treatment guidelines are available, but published literature agrees that immunocompromised patients should be treated with multiple antibiotics, tailored to the disease presentation and underlying degree of immune suppression. The outcome of M. haemophilum cervicofacial lymphadenitis in immunocompetent patients favors surgical intervention rather than antibiotic treatment.

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Section: Direct Detection Methodsmentioning

confidence: 99%

Section: Immunocompetent Patientsmentioning

confidence: 99%

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Clinical Manifestations, Diagnosis, and Treatment of Mycobacterium haemophilum Infections

et al. 2011

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“…Among immunocompetent hosts, M. haemophilum is best described as the second most common cause of cervicofacial lymphadenitis in children (8). Similar to some rapidly growing NTM species, M. haemophilum may complicate cosmetic procedures, and an outbreak of M. haemophilum skin infection and lymphadenitis occurred in 12 adults following permanent makeup of the eyebrows with contaminated ink (9).…”

Section: Discussionmentioning

confidence: 99%

The Brief Case: Disseminated Mycobacterium haemophilum Infection in a Kidney Transplant Recipient

et al. 2018

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A 65-year-old woman from Thailand was hospitalized in May 2016 with fevers and rash. The patient had end-stage renal disease and hypertension and received a deceased-donor kidney transplant in 2009. The induction immunosuppression agent was rabbit anti-thymocyte globulin, and she took tacrolimus and mycophenolate mofetil for maintenance immunosuppression. The patient was diagnosed with polymorphic, Epstein-Barr virus-positive posttransplant lymphoproliferative disorder (PTLD) of the central nervous system 5 weeks prior to admission. She completed two doses (375 mg/m 2 each) of rituximab with dexamethasone (10 to 24 mg/day in divided doses), and mycophenolate mofetil was discontinued after the PTLD diagnosis.On physical examination, the patient was ill appearing but alert and oriented. Her temperature was 38°C. The right eye conjunctiva was injected with nodular conjunctival lesions. On skin examination, there were erythematous papules, some with central pustules, on the forehead, face, neck, arms, anterior thighs, knees, and lower back (Fig. 1A). Human immunodeficiency virus antibody and tuberculosis gamma interferon release assays were performed, and both were negative. A computed tomography scan of the chest demonstrated several bilateral subcentimeter pulmonary nodules in the lower lobes and lingula.Skin biopsies were performed on the right arm, cheek, and thigh, and the samples were sent for histopathologic examination and bacterial, fungal, and mycobacterial cultures. Histopathology revealed a superficial and granulomatous reaction with a neutrophilic infiltrate involving the dermis and subcutaneous fat (Fig. 1C). Numerous acid-fast bacilli (AFB) were visualized after staining with Fite-Faraco stain (Fig. 1D). Rare AFB were observed by acid-fast fluorescent staining of tissue submitted to the clinical microbiology laboratory, and a portion of the specimen was inoculated onto chocolate agar and incubated at 30°C. Imipenem, azithromycin, levofloxacin, isoniazid, pyrazinamide, and ethambutol were administered as empirical therapy for rapidly growing mycobacterial species (Mycobacterium chelonae/Mycobacterium abscessus group and Mycobacterium fortuitum group), slowly growing mycobacterial species (Mycobacterium haemophilum and Mycobacterium marinum) that are often associated with skin lesions, and Mycobacterium tuberculosis. Aminoglycosides and rifamycins were initially avoided, given the potential for nephrotoxicity and drug interaction with tacrolimus, respectively.Two weeks after the skin biopsy, mycobacterial cultures demonstrated no growth. The skin lesions had progressed to extensive erythematous plaques and yellow/black crust covering the forehead, cheeks, both arms, and thighs. Painful ulcerations develCitation Jacobs SE, Zhong E, Hartono C, Satlin MJ, Magro CM, Jenkins SG, Westblade LF. 2018. The Brief Case: Disseminated Mycobacterium haemophilum infection in a kidney transplant recipient. J Clin Microbiol 56:e00561-17.

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“…The application of molecular assays for direct detection of M. haemophilum in clinical materials using the 16S rRNA and hsp65 genetic markers has been described in a number of case reports [7,12,13]. However, the target gene most suitable for identification of this mycobacterial species, like for other NTMs, is still unclear [6].…”

Section: Discussionmentioning

confidence: 99%

First report of cervicofacial lymphadenitis due to Mycobacterium haemophilum in an immunocompromised adult patient

Atiya

Sulaiman

Chong

et al. 2015

J Infect Dev Ctries

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We report the first case of an immunocompromised adult patient presenting with cervicofacial lymphadenitis due to Mycobacterium haemophilum, confirmed using hsp65 gene sequencing and line-probe assays. In resource-limited settings, especially in developing countries, appropriate culture methods and rapid molecular diagnostic tools such as hsp65 gene sequencing for identification of this organism may not be readily available. This may cause M. haemophilum infections to go unrecognised or lead to delays in diagnosis. Lack of heightened awareness about the potential for this mycobacterial species to cause infections may also contribute to possible underestimation of M. haemophilum cases in the developing world.

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Outbreak of Mycobacterium haemophilum Infections after Permanent Makeup of the Eyebrows

Cited by 54 publications

References 12 publications

Clinical Manifestations, Diagnosis, and Treatment of Mycobacterium haemophilum Infections

Clinical Manifestations, Diagnosis, and Treatment of Mycobacterium haemophilum Infections

The Brief Case: Disseminated Mycobacterium haemophilum Infection in a Kidney Transplant Recipient

First report of cervicofacial lymphadenitis due to Mycobacterium haemophilum in an immunocompromised adult patient

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