Sporotrichoid-Like Spread of Cutaneous<i> Mycobacterium chelonae</i> in an Immunocompromised Patient

Kemp, Daria Marley; Govind, Anusha; Jun, Kang Il; Brugger, Caroline C.; Kauh, Young C.

doi:10.1155/2017/8219841

Cited by 7 publications

(8 citation statements)

References 11 publications

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“…We entertained the diagnosis of a naturally evolving and relapsing M chelonae infection for many months, because the patient adhered reliably to therapy, endured adverse effects, presented with a seemingly sporotrichoid pattern of progression well described for M chelonae infections [ 7 ], and experienced apparently treatment-related emergence of a rrl gene mutation conferring clarithromycin resistance ( Supplementary Data ). Because difficult-to-treat M chelonae infections are primarily encountered in immunocompromised patients [ 8 ], we even planned a diagnostic work-up for genetic Mendelian susceptibility to mycobacterial disease [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Recurrent Mycobacterium chelonae Skin Infection Unmasked as Factitious Disorder Using Bacterial Whole Genome Sequence Analysis

Flohr

Ramette

Agyeman

et al. 2020

Open Forum Infectious Diseases

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Section: Discussionmentioning

confidence: 99%

Recurrent Mycobacterium chelonae Skin Infection Unmasked as Factitious Disorder Using Bacterial Whole Genome Sequence Analysis

Flohr

Ramette

Agyeman

et al. 2020

Open Forum Infectious Diseases

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“…Skin lesions may appear as erythematous or violaceous papules or plaques, pustules, folliculitis, or panniculitis (1-3, 5, 6). In rare cases, the infection may also present with a "sporotrichoid" pattern, spreading along subcutaneous lymphatics from the site of entry (32). Later on, skin lesions can become erosive or ulcerated (1-3, 5, 6).…”

Section: Discussionmentioning

confidence: 99%

Skin and Soft Tissue Infections Caused by Mycobacterium chelonae: More Common Than Expected?

Uslu¹,

Böhm²,

Heppt³

et al. 2019

Acta Derm Venerol

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Patients can present with infections of the skin and soft tissues due to the pathogen Mycobacterium chelonae. Clinical presentation of this relatively rare infectious disease may differ from individual to individual. Despite an increasing incidence, affected patients are often misdiagnosed. Thus, in addition to careful history-taking, tissue biopsies for mycobacterial culture and histopathological examination are needed to reach a correct diagnosis. Once diagnosed, culture-directed antibiotic therapy is required. We report here 5 patients with cutaneous and/or soft-tissue infections due to M. chelonae, who were diagnosed and treated appropriately at our centre. Mycobacterium chelonae is a rapidly growing nontuber culous mycobacterium, which causes infections of the human skin and soft tissue. Despite an increasing incidence of such infections, patients are often misdiagnosed. We report here 5 patients with cutaneous and/ or soft tissue infection due to M. chelonae who were diagnosed and treated at our centre. Two of the 5 patients were on immunosuppressive treatment. While clinical presentations differed in each patient, all had a long history of skin lesions. In addition to careful history-taking, tissue biopsies were obtained for mycobacterial culture and histopathological examination. Culturedirected antibiotic therapy was initiated, which resulted in a slow, but continuous, healing of the lesions. In summary, M. chelonae infections are still relatively rare, but should be considered in both immunocompromised and immunocompetent patients with prolonged skin lesions resistant to standard antibiotic treatment. For diagnosis, tissue analysis for mycobacterial culture and histopathological examination, and once diagnosed, adequate antibiotic treatment, is needed.

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“…In a review of the literature (1987–2017, conducted through PubMed), we identified 14 2,3,10–22 cases of cutaneous M. chelonae infection presenting with a sporotrichoid pattern of spread. The vast majority of these cases (80%; 11/14) occurred in immunocompromised patients.…”

Section: Discussionmentioning

confidence: 99%

Recurrence of cutaneous Mycobacterium chelonae infection: A case report

DuBow

Morand

Désy

et al. 2019

SAGE Open Medical Case Reports

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Mycobacterium chelonae is a species of mycobacteria that can be found ubiquitously in the environment. It can be found in soil, water, and in aquatic animals. Infections with this pathogen usually involve the soft tissues, eyes, bones, and skin. We present the case of a recurrence of a sporotrichoid cutaneous infection by M. chelonae in an immunocompromised 31-year-old woman with systemic lupus erythematosus. The patient originally developed a swelling of her right foot followed by a sporotrichoid pattern of infection on her right lower leg. A susceptibility profile was established, and treatment with linezolid and clarithromycin was administered for 8 months, in accordance with guidelines from the American Thoracic Society. The patient was clear of new lesions for approximately 1 month before noting a re-emergence. Treatment with linezolid and clarithromycin was re-initiated with subsequent improvement. This case underlines the need for prolonged treatment of this infection in patients with an immunocompromised status.

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Sporotrichoid-Like Spread of Cutaneous Mycobacterium chelonae in an Immunocompromised Patient

Cited by 7 publications

References 11 publications

Recurrent Mycobacterium chelonae Skin Infection Unmasked as Factitious Disorder Using Bacterial Whole Genome Sequence Analysis

Recurrent Mycobacterium chelonae Skin Infection Unmasked as Factitious Disorder Using Bacterial Whole Genome Sequence Analysis

Skin and Soft Tissue Infections Caused by Mycobacterium chelonae: More Common Than Expected?

Recurrence of cutaneous Mycobacterium chelonae infection: A case report

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