Atypical Mycobacterial Cutaneous Infections
Section snippets
Classification
The genus mycobacterium is divided into obligate and facultative pathogens. The obligate group involves M tuberculosis and M leprae. The facultative group is divided into slow-growing and rapid-growing mycobacteria. Runyon further classified the slow-growing mycobacteria based on their ability to produce pigment, growth rate, and optimal temperature.3, 4 This classification is depicted in Table 1.
Photochromogens produce pigment only when exposed to light. Scotochromogens produce pigment under
Mycobacterium Marinum (Mycobacterium Balnei or Mycobacterium Platypoecilus)
M marinum is a slow-growing photochromogen that usually causes disease in fish but can cause human disease by penetration through impaired skin barrier. It was first discovered in 1926 by Aronson who isolated the organism from a saltwater fish in a Philadelphia aquarium.5 The first human case was reported in 1951 in a patient who developed granulomatous lesions after visiting a contaminated swimming pool.6 The disease caused by M marinum is sometimes referred to as swimming pool granuloma or
Mycobacterium Scrofulaceum
M scrofulaceum is a slow-growing scotochromogen that produces light yellow to orange pigment when exposed to both light and dark conditions. It is most prevalent in southeastern United States.47 It has been isolated from raw milk and other dairy products, pooled oysters, soil, and water.48 Cutaneous infections from M scrofulaceum are rare and usually are part of disseminated infection involving internal organs and the integumentary system. Immunocompromised patients, such as those who have
Mycobacterium Avium-Intracellulare
M avium-intracellulare complex (MAC) consists of M avium, M intracellulare, and other unidentified species. Because it is not possible to differentiate between M avium and M intracellulare by normal biochemical means they are usually grouped together. The sensitization to M intracellulare was shown to be increasing by Khan and colleagues58 from 1 in 9 people in 1971 to 1972 to 1 in 6 people in 1999 to 2000, which corresponded to the increased number of pulmonary NTM infections in the USA.
MAI is
Mycobacterium Fortuitum
M fortuitum is a rapid grower that is widely distributed in the environment and found in soil, dust, water, milk, marine life, biofilm, and saliva of healthy humans.12, 40 Colonies are visible in 1 week or less. Outbreaks caused by rapid growers, such as M fortuitum and M chelonei, have been associated with jet injectors, hemodialysis, peritoneal dialysis, contaminated gentian violet skin-marking solution, catheters, prosthetic valves, surgical site infections, nail salons, full-face skin
Summary
Atypical mycobacteria infections have been increasing over the past few decades and thus we have to be aware of their clinical presentation. Clinical features may vary from chronic localized skin infections to cervical lymphadenitis. The most common presentation in children is adenitis. Rapid growers, such as M fortuitum and M chelonei, may present as both cutaneous and lymph node infections, whereas M marinum only causes cutaneous disease. Biopsy should be done for histopathology diagnosis.
References (77)
Anonymous mycobacteria in pulmonary disease
Med Clin North Am
(1959)Unusual cutaneous mycobacterial diseases
Clin Dermatol
(1995)- et al.
Diseases caused by Mycobacterium scrofulaceum
Clin Dermatol
(1995) - et al.
Dermatologic manifestations of nontuberculous mycobacterial diseases
Infect Dis Clin North Am
(1994) - et al.
Nontuberculous mycobacterial infections of the skin: a retrospective study of 25 cases
J Am Acad Dermatol
(2007) - et al.
Atypical mycobacterial infections of the skin
Dermatol Clin
(1994) - et al.
Nontuberculous mycobacterial infections of the skin
Dermatol Clin
(2000) - et al.
Atypical mycobacterial infections of the hand: report of eight cases and literature review
Chir Main
(2001) - et al.
Mycobacterium other than tuberculosis (MOTT) infection: an emerging disease in infliximab-treated patients
J Infect
(2007) Atypical mycobacterial cutaneous infection
Clin Dermatol
(1999)
Postoperative infection of laparoscopic surgery wound due to Mycobacterium chelonae
Indian J Med Microbiol
Successful recovery after disseminated infection due to mycobacterium abscessus in a lung transplant patient: subcutaneous nodule as first manifestation—a case report
Transplant Proc
Nontuberculous mycobacterial infections of the skin. Report of fourteen cases and review of the literature
J Am Acad Dermatol
Disseminated Mycobacterium simiae infection in patients with AIDS
J Infect
Multifocal osteomyelitis due to Mycobacterium szulgai in a patient with chronic lymphocytic leukemia
J Infect
Mycobacterium avium-intracellulare: cutaneous presentations of disseminated disease
Am J Med
A preliminary report on characterization and identification of non tuberculous mycobacteria (NTM) on the basis of biochemical tests and protein/isoenzyme electrophoretic patterns
Indian J Med Microbiol
Atypical Mycobacterium furunculosis occurring after pedicures
J Am Acad Dermatol
Therapy of nontuberculous mycobacterial infections
Dermatol Ther
Atypical mycobacterial cutaneous infections in Hong Kong: 10-year retrospective study
Hong Kong Med J
Pathogenic mycobacteria
Bibl Tuberc
Spaontaneous tuberculosis in salt water fish
J Infect Dis
A new type of pathogenic mycobacterium
Nature
Atypical mycobacterial infection
Bol Asoc Med P R
Septic arthritis due to Mycobacterium marinum
J Rheumatol
Mycobacterium marinum tenosynovitis in a patient on etanercept therapy for rheumatoid arthritis
J Clin Rheumatol
Mycobacterium marinum arthritis mimicking rheumatoid arthritis
J Rheumatol
Severe sporotrichoid fish tank granuloma following infliximab therapy
Am J Clin Dermatol
Mycobacterium marinum causing tenosynovitis. “Fish tank finger”
Acta Orthop Belg
The histopathologic spectrum in Mycobacterium marinum infection
Arch Pathol Lab Med
Emerging infections in dermatology
Semin Cutan Med Surg
Atypical mycobacterial infections: a difficult and emerging group of infectious dermatoses
Int J Dermatol
Sporothricoid mycobacterial infection. A case report
Acta Derm Venereol
Nontuberculous mycobacterial skin infections: clinical and bacteriological studies
J Med Assoc Thai
Localization of Mycobacterium avium-intracellulare within a skin lesion of bacillary angiomatosis in a patient with AIDS
Diagn Mol Pathol
Clinical patterns of cutaneous nontuberculous mycobacterial infections
Br J Dermatol
Mycobacterium marinum cutaneous infections acquired from occupations and hobbies
Int J Dermatol
Atypical cutaneous mycobacteriosis diagnosed by polymerase chain reaction
Br J Dermatol
Cited by (66)
Systemic Antibacterial Agents
2020, Comprehensive Dermatologic Drug Therapy, Fourth EditionSkin and soft tissue infection by Mycobacterium intracellulare in an immunocompetent patient
2020, IDCasesCitation Excerpt :Cutaneous infection from M intracellulare has a protean clinical presentation such as abscesses, nodular lesions, erythematous plaques with yellow-crusted bases or ulcerations. Deeper infections such as panniculitis, tenosynovitis and fasciitis have also been described [3]. In our case the patient presented chronic ulcerated lesions, while CT and MRI examinations showed a deeper involvement of subcutaneous tissue up to the periosteum of the metatarsal bones.
Cutaneous infection by Mycobacterium lentiflavum after subcutaneous injection of lipolytic formula
2020, Anais Brasileiros de DermatologiaDermoscopy in Mycobacterium marinum infection and its correlation with clinical and histopathological features: a prospective observational study
2023, Clinical and Experimental Dermatology