Mycobacterium chelonae Cutaneous Infection: A Challenge for an Internist
  • Margarida Gaudencio
    Department of Internal Medicine, Hospital Distrital da Figueira da Foz, EPE, Figueira da Foz, Portugal
  • André Carvalho
    Department of Internal Medicine, Hospital Distrital da Figueira da Foz, EPE, Figueira da Foz, Portugal
  • Maria Inês Bertão
    Department of Internal Medicine, Hospital Distrital da Figueira da Foz, EPE, Figueira da Foz, Portugal
  • Ivo Barreiro
    Department of Internal Medicine, Hospital Distrital da Figueira da Foz, EPE, Figueira da Foz, Portugal
  • Maria Isabel Bessa
    Department of Internal Medicine, Hospital Distrital da Figueira da Foz, EPE, Figueira da Foz, Portugal
  • Abílio Gonçalves
    Department of Internal Medicine, Hospital Distrital da Figueira da Foz, EPE, Figueira da Foz, Portugal

Keywords

Mycobacterium chelonae, cutaneous infection, immunosuppression, atypical specimens

Abstract

Cutaneous infections caused by the Mycobacterium chelonae complex show a heterogeneous clinical presentation, which varies according to the patient’s immune status. Most standard antimycobacterials have no effect against these species. Clarithromycin alone was shown to provide adequate treatment, although resistance has been reported. Consequently, the literature supports multi-drug therapy to combat resistant strains. Here, we describe the case of a 59-year-old man under systemic immunosuppressive therapy who developed cutaneous lesions whose evolution was highly suggestive of atypical infection.

VIEW THE ENTIRE ARTICLE

References

  • Kullavanijaya P. Atypical mycobacterial cutaneous infection. Clin Dermatol 1999;17:153–158; discussion 105–106.
  • Halpern J, Biswas A, Cadwgan A, Tan BB. Disseminated cutaneous Mycobacterium chelonae infection in an immunocompetent host. Clin Exp Dermatol 2010;35:269–271.
  • Chung WK, Kim MS, Kim CH, Lee MW, Choi JH, Moon KC, et al. Cutaneous Mycobacterium chelonae infection presenting as symmetrical plaques on both shins in an immunocompetent patient. Acta Derm Venereol 2009;89:663–664.
  • Haas SR, Hodge MB, Duncan RA. Cushing’s syndrome presenting as disseminated cutaneous Mycobacterium chelonaeinfection. Clin Infect Dis 2001;33:e51–e53.
  • Kane CL, Vincent AL, Greene JN, Sandin RL. Disseminated cutaneous Mycobacterium chelonae infection. Cancer Control 2000;7:181–184.
  • Bartralot R, Pujol RM, García-Patos V, Sitjas D, Martín-Casabona N, Coll P, et al. Cutaneous infections due to nontuberculous mycobacteria: histopathological review of 28 cases. Comparative study between lesions observed in immunosuppressed patients and normal hosts. J Cutan Pathol 2000;27(3):124–129.
  • Phillips K, Blackford S, Berry N. Disseminated cutaneous Mycobacterium chelonae infection with multidrug resistance in a patient with panuveitis. Clin Exp Dermatol 2008;33(3):256–258.
  • Lapresta A, Pérez C, García-Almagro D. Lesiones faciales tras tatuajes. Actas Dermosifiliogr 2010;101:889–890.
  • Iseman M. Group IV: rapid growing mycobacteria. In: Yu VL, Merigan TC, Barriere SL, editors. Antimicrobial therapy and vaccines. Philadelphia: William & Wilkins; 1999, pp. 494–497.
  • Morihara K, Takenaka H, Morihara T, Katoh N. Cutaneous Mycobacterium chelonae infection successfully treated with faropenem. J Dermatol 2011;38:211–213.
  • Wallace RJ Jr, Brown BA, Onyi GO. Skin, soft tissue, and bone infections due to Mycobacterium chelonae chelonae: importance of prior corticosteroid therapy, frequency of disseminated infections, and resistance to oral antimicrobials other than clarithromycin. J Infect Dis 1992;166:405–412.
  • Kullavanijaya P, Rattana-Apiromyakij N, Sukonthapirom-Napattalung P, Sirimachand S, Duangdeeden I. Disseminated Mycobacterium chelonae cutaneous infection: recalcitrant to combined antibiotic therapy. J Dermatol 2003;30:485–491.
  • Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F, et al. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med 2007;175(4):367–416.

    • Views: 564
    HTML downloads: 107
    PDF downloads: 242

    Published: 2021-11-15
    Issue: 2021: Vol 8 No 11 (view)

    How to cite:
    1.
    Gaudencio M, Carvalho A, Bertão MI, Barreiro I, Bessa MI, Gonçalves A. Mycobacterium chelonae Cutaneous Infection: A Challenge for an Internist. EJCRIM 2021;8 doi:10.12890/2021_003013.