101
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Lee CN, Lee JYY. Local hyperthermia therapy for refractory cutaneous Mycobacterium marinum
infection. Dermatol Ther 2017; 30. [DOI: 10.1111/dth.12561] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 09/24/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Chaw-Ning Lee
- Department of Dermatology; National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University; Tainan Taiwan
| | - Julia Yu-Yun Lee
- Department of Dermatology; National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University; Tainan Taiwan
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102
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Romero FA, Powell EA, Babady NE, Kaltsas A, Figueroa CJ, Pulitzer M, Mehrara BJ, Glickman MS, Morjaria S. Nontuberculous Mycobacterial Infections After Silicone Breast Implant Reconstruction Emphasize a Diversity of Infecting Mycobacteria. Open Forum Infect Dis 2017; 4:ofx189. [PMID: 29308399 PMCID: PMC5751029 DOI: 10.1093/ofid/ofx189] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 08/14/2017] [Indexed: 11/14/2022] Open
Abstract
Postsurgical skin and soft tissue infections (SSTIs) caused by nontuberculous mycobacteria (NTM) are uncommon, indolent, difficult to treat, and often mimic pyogenic bacterial infections. Here we present 3 cases of NTM infections following placement of silicone implants for reconstructive breast surgery. These cases emphasize the importance of a high index of suspicion for NTM in patients with SSI after a prosthetic reconstruction refractory to conventional antibiotic therapy and the importance of early investigation with mycobacterial-specific diagnostics.
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Affiliation(s)
- Fabian A Romero
- Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Eleanor A Powell
- Clinical Microbiology Service, Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - N Esther Babady
- Clinical Microbiology Service, Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Anna Kaltsas
- Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Division of Plastic and Reconstructive Surgery, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Cesar J Figueroa
- Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Division of Plastic and Reconstructive Surgery, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Melissa Pulitzer
- Department of Pathology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Babak J Mehrara
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michael S Glickman
- Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sejal Morjaria
- Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
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103
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104
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Oaku S, Nagata M, Miyamoto Y, Ishii N, Aozasa N. Two cases of Mycobacterium marinum infection on the upper limbs. J Dermatol 2017; 44:e270-e271. [PMID: 28556948 DOI: 10.1111/1346-8138.13920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Satoe Oaku
- Department of Dermatology, Kosei General Hospital, Tokyo, Japan
| | - Mayumi Nagata
- Department of Dermatology, Kosei General Hospital, Tokyo, Japan
| | - Yuji Miyamoto
- Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Norihisa Ishii
- Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Naohiko Aozasa
- Department of Dermatology, Kosei General Hospital, Tokyo, Japan
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105
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Li JJ, Beresford R, Fyfe J, Henderson C. Clinical and histopathological features of cutaneous nontuberculous mycobacterial infection: a review of 13 cases. J Cutan Pathol 2017; 44:433-443. [PMID: 28098393 DOI: 10.1111/cup.12903] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 01/09/2017] [Accepted: 01/11/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND The incidence of cutaneous nontuberculous mycobacterial (NTM) infection has increased in recent decades because of widespread use of immunosuppressive therapy and better detection methods. The histopathology of cutaneous NTM infection is not pathognomic and the organisms are slow and difficult to culture, making diagnosis challenging. METHODS We reviewed the clinical and histopathological features of 13 cases of cutaneous NTM infection, and performed panmycobacterial polymerase chain reaction (PCR) on the paraffin blocks. RESULTS The immunocompetent patients presented with localized lesions on the extremities, whereas the immunocompromised patients presented with disseminated cutaneous lesions. The histopathology in immunocompetent patients was characterized by pseudoepitheliomatous epidermal hyperplasia, intraepithelial abscesses, transepidermal elimination and dermal granulomatous inflammation accompanied by necrosis and suppuration. The immunocompromised patients showed suppurative inflammation with little granuloma formation and numerous acid-fast bacilli. Paraffin block PCR was positive in 4 of 13 cases (31%), whereas culture was positive in 11 of 13 cases (85%). CONCLUSION The aforementioned histological features should help in diagnosing cutaneous NTM infection when combined with clinical and microbiological correlation. In our study, we did not find paraffin block PCR to be superior to conventional culture in detecting cutaneous NTM infection.
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Affiliation(s)
- Jing Jing Li
- Department of Anatomical Pathology, Liverpool Hospital, Liverpool, Australia
| | - Rohan Beresford
- Department of Microbiology and Infectious diseases, Liverpool Hospital, Liverpool, Australia
| | - Janet Fyfe
- Mycobacterium Reference Laboratory Victorian Infectious Diseases Reference Laboratory, North Melbourne, Australia
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106
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Abstract
Occupational and recreational aquatic activity predisposes our population to a wide variety of dermatoses. Sunburn, urticaria, jellyfish stings, and contact dermatitis to rubber equipment are common allergies that are encountered in the aquatic environment. Among the infections, tinea versicolor, intertrigo, and verruca vulgaris are widespread. Swimmer's itch may occur due to skin penetration by schistosome cercariae, while free-floating nematocysts of marine coelenterates may precipitate seabather's eruption. "Suit squeeze" due to cutaneous barotrauma and lymphoedematous peau d'orange due to decompression are rare, described entities. This review serves as a ready reckoner for Indian dermatologists and medical practitioners to identify and manage these conditions.
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107
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Zhang L, Jiang Y, Cui Z, Yang W, Yue L, Ma Y, Shi S, Wang C, Wang C, Qian A. Mycobacterium vaccae induces a strong Th1 response that subsequently declines in C57BL/6 mice. J Vet Sci 2016; 17:505-513. [PMID: 27994210 PMCID: PMC5204028 DOI: 10.4142/jvs.2016.17.4.505] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 12/24/2015] [Accepted: 03/04/2016] [Indexed: 11/20/2022] Open
Abstract
Mycobacterium (M.) vaccae is a fast-growing species of saprophytic bacteria that is widely distributed. To understand the host immune responses induced by M. vaccae isolated from bovine submaxillary lymph nodes, C57BL/6 mice were infected with reference strain M. bovis Bacillus Calmette-Guérin (BCG) and isolated M. vaccae using intraperitoneal injections. Comparison of the bacterial replication and organ pathology between M. vaccae and M. bovis BCG revealed that M. vaccae was more malignant than M. bovis in mice. We also demonstrated that serum from the M. vaccae-infected mice contained a higher expression level of gamma-interferon (IFN-γ), tumor necrosis factor alpha, monocyte chemoattractant protein-1, interleukin (IL)-4, IL-12, IL-10 and transforming growth factor beta than did the other groups, especially after week 4. Furthermore, when the numbers of CD3⁺CD4⁺IFN-γ⁺ and CD3⁺CD4⁺IL4⁺cells in the infected mice were observed by flow cytometry, we found that a powerful T helper 1 (Th1) response was induced by M. vaccae infection, which was associated with the emergence of CD3⁺CD4⁺IFN-γ⁺cells. However, the Th1 response declined over time, which was associated with appearance of the CD4⁺CD25⁺FoxP3⁺ and CD4⁺CD25⁺CD152⁺Treg cell reaction. In addition, a strong Th2 response was found. Finally, we found that M. vaccae infection increased the production of type I IFNs, which was associated with a reduced Th1 response.
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Affiliation(s)
- Lijiao Zhang
- College of Animal Science and Technology, Jilin Agricultural University, Changchun 130118, China
- College of Biological Science, Changchun Teacher University, Changchun 130032, China
| | - Yanlong Jiang
- College of Animal Science and Technology, Jilin Agricultural University, Changchun 130118, China
| | - Ziyin Cui
- College of Animal Science and Technology, Jilin Agricultural University, Changchun 130118, China
| | - Wentao Yang
- College of Animal Science and Technology, Jilin Agricultural University, Changchun 130118, China
| | - Limin Yue
- College of Animal Science and Technology, Jilin Agricultural University, Changchun 130118, China
| | - Yingcong Ma
- College of Animal Science and Technology, Jilin Agricultural University, Changchun 130118, China
| | - Shaohua Shi
- College of Animal Science and Technology, Jilin Agricultural University, Changchun 130118, China
| | - Chunfang Wang
- College of Animal Science and Technology, Jilin Agricultural University, Changchun 130118, China
| | - Chunfeng Wang
- College of Animal Science and Technology, Jilin Agricultural University, Changchun 130118, China
| | - Aidong Qian
- College of Animal Science and Technology, Jilin Agricultural University, Changchun 130118, China
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108
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Atypical Mycobacterial Infection after Abdominoplasty Overseas: A Case Report and Literature Review. Case Rep Infect Dis 2016; 2016:3642567. [PMID: 28116185 PMCID: PMC5223012 DOI: 10.1155/2016/3642567] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 12/12/2016] [Indexed: 12/05/2022] Open
Abstract
Increasing number of medical tourists travel internationally for cosmetic procedures. Lipotourism is a form of medical tourism becoming popular among patients of developed countries due to the cost efficiency of cosmetic procedures when performed in developing nations. There is a paucity of data on quality, safety, and risks involved with these surgeries. Many cases of infections have been documented in patients following cosmetic surgeries in developing countries. We present a case of a 34-year-old female who underwent abdominoplasty in Dominican Republic that was complicated with development of multiple abdominal wall abscesses due to infection from rapidly growing mycobacteria (RGM). In the absence of clear treatment guidelines, she was treated with a combination of intermittent surgical drainage and prolonged antibiotic course. This case is of interest as more than one species of RGM was isolated from the same patient. Our case highlights the fact that identification of these organisms can be difficult requiring referral of samples to specialized laboratories and treatment duration can last several months, which is determined by clinical and microbiological response.
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109
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Mitteldorf C, Tronnier M. Histologic features of granulomatous skin diseases. J Dtsch Dermatol Ges 2016; 14:378-88. [PMID: 27027748 DOI: 10.1111/ddg.12955] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Granulomatous disorders affecting the skin belong to a heterogeneous group of diseases, which were predominantly classified based on pathogenetic features. In infections diseases a granuloma is formed if an agent could not be eliminated by the immune system. Typical agents which cause granulomatous reactions are mycobacteria, fungal infections, especially extra European agent, which could effect the skin by, dissemination (e.g. histoplasmosis) or parasites, like leishmaniasis.
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Affiliation(s)
- Christina Mitteldorf
- Department of Dermatology, Venereology, and Allergology, HELIOS Hospital, Hildesheim, Germany
| | - Michael Tronnier
- Department of Dermatology, Venereology, and Allergology, HELIOS Hospital, Hildesheim, Germany
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110
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Blanc P, Dutronc H, Peuchant O, Dauchy FA, Cazanave C, Neau D, Wirth G, Pellegrin JL, Morlat P, Mercié P, Tunon-de-Lara JM, Doutre MS, Pélissier P, Dupon M. Nontuberculous Mycobacterial Infections in a French Hospital: A 12-Year Retrospective Study. PLoS One 2016; 11:e0168290. [PMID: 27959960 PMCID: PMC5154556 DOI: 10.1371/journal.pone.0168290] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 11/29/2016] [Indexed: 01/08/2023] Open
Abstract
Background Nontuberculous mycobacteria (NTM) are environmental organisms associated with a range of infections. Reports of NTM epidemiology are mainly focused on pulmonary infections and isolations, and extrapulmonary infections are less frequently described. Methods We conducted a retrospective study of NTM infections at the Bordeaux University Hospital, France, between January 2002 and December 2013. We used the microbiologic component of the American Thoracic Society/Infectious Diseases Society of America's pulmonary NTM disease criteria to define cases of pulmonary NTM, and patients with isolates from a normally sterile site were classified as having extrapulmonary disease. Results In our setting, 170 patients were included. Pulmonary cases predominated (54.1%), followed by skin and soft tissue infections (22.9%), disseminated cases (10.6%), lymphadenitis (7.7%), bone and joint infections (2.9%) and the remaining 1.8% catheter-related infections. Overall, 16 NTM species were isolated. Mycobacterium avium (31.8%) and M. intracellulare (20%) were the most common species identified, followed by M. marinum (13.5%), M. kansasii (10.6%), M. xenopi (9.4%), rapidly growing mycobacteria (9.4%) and other slowly growing mycobacteria (5.3%). In general, NTM isolates were largely prevalent in people older than 50 (62.4%); patients aged 1–10 year-old exclusively yielded M. avium from lymph nodes, almost cases having being diagnosed after 2007. Among the 121 patients with complete follow-up, 78 (64.5%), 24 (19.8%), and 19 (15.7%) were cured, experienced relapse, or died, respectively. Conclusion In our study, extrapulmonary NTM infections represented almost half of cases, consisting mainly in skin and soft tissue infections. The increase lymphadenitis cases in children after 2007 could be linked to the cessation of mandatory BCG vaccination in France. We observed similar cure rates (64%) between pulmonary and extrapulmonary infections.
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Affiliation(s)
- Peggy Blanc
- Service de maladies infectieuses et tropicales, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Hervé Dutronc
- Service de maladies infectieuses et tropicales, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Olivia Peuchant
- Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
- Université de Bordeaux, Infections humaines à mycoplasmes et à chlamydiae, Bordeaux, France
- INRA, Infections humaines à mycoplasmes et à chlamydiae, Bordeaux, France
- * E-mail:
| | - Frédéric-Antoine Dauchy
- Service de maladies infectieuses et tropicales, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Charles Cazanave
- Service de maladies infectieuses et tropicales, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Didier Neau
- Service de maladies infectieuses et tropicales, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Gaëtane Wirth
- Service de maladies infectieuses et tropicales, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Jean-Luc Pellegrin
- Service de médecine interne, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Philippe Morlat
- Service de médecine interne, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Patrick Mercié
- Service de médecine interne, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | | | - Marie-Sylvie Doutre
- Service de dermatologie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Philippe Pélissier
- Service de chirurgie plastique, reconstructrice et esthétique -brulés- chirurgie de la main, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Michel Dupon
- Service de maladies infectieuses et tropicales, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
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111
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Smith BD, Liras IN, De Cicco IA, Aisenberg GM. Mycobacterium fortuitum infection of the scalp after a skin graft. BMJ Case Rep 2016; 2016:bcr-2016-216968. [PMID: 27797799 DOI: 10.1136/bcr-2016-216968] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Mycobacterium fortuitum is a non-tuberculous mycobacterium found in the soil and water of most regions of the world, and it can cause disease in immunocompetent and immunocompromised hosts. We present a 52-year-old man who developed a scalp abscess under a free flap for cranium coverage after a motor vehicle accident. Culture of material drained from the abscess grew M. fortuitum.
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Affiliation(s)
- Blaine D Smith
- Department of Internal Medicine, University of Texas, McGovern School of Medicine, Houston, Texas, USA
| | - Ioannis N Liras
- Department of Internal Medicine, University of Texas, McGovern School of Medicine, Houston, Texas, USA
| | - Ignacio A De Cicco
- Department of Internal Medicine, University of Texas, McGovern School of Medicine, Houston, Texas, USA
| | - Gabriel Marcelo Aisenberg
- Department of Internal Medicine, University of Texas, McGovern School of Medicine, Houston, Texas, USA
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112
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Cook IF. Sepsis, parenteral vaccination and skin disinfection. Hum Vaccin Immunother 2016; 12:2546-2559. [PMID: 27295449 PMCID: PMC5084982 DOI: 10.1080/21645515.2016.1190489] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 04/25/2016] [Accepted: 05/12/2016] [Indexed: 11/21/2022] Open
Abstract
ASBSTRACT Disinfection should be required for all skin penetrative procedures including parenteral administration of vaccines. This review analyses medically attended infectious events following parenteral vaccination in terms of their microbiological aetiology and pathogenesis. Like 'clean' surgical site infections, the major pathogens responsible for these events were Staphylococcal species, implicating endogenous con-tamination as a significant source of infection. As 70% isopropyl alcohol swabbing has been shown to effectively disinfect the skin, it would be medico-legally difficult to defend a case of sepsis with the omission of skin disinfection unless the very low risk of this event was adequately explained to the patient and documented prior to vaccination. There was a significant cost-benefit for skin disinfection and cellulitis. Skin disinfection in the context of parenteral vaccination represents a new paradigm of medical practice; the use of a low cost intervention to prevent an event of very low prevalence but of significant cost.
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Affiliation(s)
- Ian F. Cook
- University of Newcastle, Callaghan, New South Wales, Australia
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113
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Shah NM, Davidson JA, Anderson LF, Lalor MK, Kim J, Thomas HL, Lipman M, Abubakar I. Pulmonary Mycobacterium avium-intracellulare is the main driver of the rise in non-tuberculous mycobacteria incidence in England, Wales and Northern Ireland, 2007-2012. BMC Infect Dis 2016; 16:195. [PMID: 27154015 PMCID: PMC4858927 DOI: 10.1186/s12879-016-1521-3] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Accepted: 04/19/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The incidence of non-tuberculous mycobacteria (NTM) isolation from humans is increasing worldwide. In England, Wales and Northern Ireland (EW&NI) the reported rate of NTM more than doubled between 1996 and 2006. Although NTM infection has traditionally been associated with immunosuppressed individuals or those with severe underlying lung damage, pulmonary NTM infection and disease may occur in people with no overt immune deficiency. Here we report the incidence of NTM isolation in EW&NI between 2007 and 2012 from both pulmonary and extra-pulmonary samples obtained at a population level. METHODS All individuals with culture positive NTM isolates between 2007 and 2012 reported to Public Health England by the five mycobacterial reference laboratories serving EW&NI were included. RESULTS Between 2007 and 2012, 21,118 individuals had NTM culture positive isolates. Over the study period the incidence rose from 5.6/100,000 in 2007 to 7.6/100,000 in 2012 (p < 0.001). Of those with a known specimen type, 90 % were pulmonary, in whom incidence increased from 4.0/100,000 to 6.1/100,000 (p < 0.001). In extra-pulmonary specimens this fell from 0.6/100,000 to 0.4/100,000 (p < 0.001). The most frequently cultured organisms from individuals with pulmonary isolates were within the M. avium-intracellulare complex family (MAC). The incidence of pulmonary MAC increased from 1.3/100,000 to 2.2/100,000 (p < 0.001). The majority of these individuals were over 60 years old. CONCLUSION Using a population-based approach, we find that the incidence of NTM has continued to rise since the last national analysis. Overall, this represents an almost ten-fold increase since 1995. Pulmonary MAC in older individuals is responsible for the majority of this change. We are limited to reporting NTM isolates and not clinical disease caused by these organisms. To determine whether the burden of NTM disease is genuinely increasing, a standardised approach to the collection of linked national microbiological and clinical data is required.
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Affiliation(s)
- Neeraj M Shah
- Division of Asthma, Allergy and Lung Biology, King's College London, London, UK.,TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK.,, 49 Bodley Road, New Malden, Surrey, KT3 5QD, UK
| | - Jennifer A Davidson
- TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - Laura F Anderson
- TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - Maeve K Lalor
- TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - Jusang Kim
- MRC Clinical Trials Unit and Centre for Infectious Disease Epidemiology, University College London, London, UK
| | - H Lucy Thomas
- TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - Marc Lipman
- UCL Respiratory, Division of Medicine, University College London, London, UK.
| | - Ibrahim Abubakar
- TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK.,MRC Clinical Trials Unit and Centre for Infectious Disease Epidemiology, University College London, London, UK
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114
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Mitteldorf C, Tronnier M. Histologische Merkmale granulomatöser Hauterkrankungen: Teil 2: Infektiöse granulomatöse Erkrankungen. J Dtsch Dermatol Ges 2016. [DOI: 10.1111/ddg.12955_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Christina Mitteldorf
- Klinik für Dermatologie, Venerologie und Allergologie; HELIOS Klinikum; Hildesheim
| | - Michael Tronnier
- Klinik für Dermatologie, Venerologie und Allergologie; HELIOS Klinikum; Hildesheim
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Recurrent pocket infection due to Mycobacterium chelonae at the site of an explanted cardiac implantable electrical device in proximity to a long-standing tattoo. HeartRhythm Case Rep 2016; 2:132-134. [PMID: 27014568 PMCID: PMC4785634 DOI: 10.1016/j.hrcr.2015.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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116
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Asakura T, Ishii M, Kikuchi T, Kameyama K, Namkoong H, Nakata N, Sugita K, Tasaka S, Shimizu T, Hoshino Y, Okamoto S, Betsuyaku T, Hasegawa N. Disseminated Mycobacterium marinum Infection With a Destructive Nasal Lesion Mimicking Extranodal NK/T Cell Lymphoma: A Case Report. Medicine (Baltimore) 2016; 95:e3131. [PMID: 26986167 PMCID: PMC4839948 DOI: 10.1097/md.0000000000003131] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Mycobacterium marinum is a ubiquitous waterborne organism that mainly causes skin infection in immunocompetent patients, and its disseminated infection is rare. Extranodal NK/T cell lymphoma, nasal type (ENKL) usually localizes at the nasal and/or paranasal area, but occasionally disseminates into the skin/soft tissue and gastrointestinal tract. Compromised immunity is a risk factor for developing nontuberculous mycobacterial (NTM) infection and malignant lymphoma, and the 2 diseases may share similar clinical presentation; however, only a few reports have described NTM infection mimicking malignant lymphoma.A 43-year-old Japanese man presented to our hospital complaining of multiple progressive skin nodules and purulent nasal discharge for 3 weeks. He was diagnosed with Crohn disease with refractory enteropathic arthritis and has been treated with anti-tumor necrosis factor alpha agents for 25 years. Fiberoptic nasal examination revealed septal perforation with hemorrhagic mucus and purulent rhinorrhea. Histological examination of the nasal septum revealed the infiltration of atypical medium-to-large-sized cells with erosion. The cells were positive for cytoplasmic CD3, granzyme B, and Epstein-Barr virus-encoded small RNA. Histological examination of the skin nodules and auricle also showed infiltration of atypical lymphocytes. The patient was tentatively diagnosed with ENKL, and chemotherapy was considered. However, the skin lesions decreased in size after discontinuation of immunosuppressive agents and minocycline administration. Two weeks later, nasal septum and lavage fluid and left leg skin cultures were positive for M marinum, and minocycline was discontinued. The skin and the nasal lesions improved after 2 months. To the best of our knowledge, this is the first case of disseminated M marinum infection with a destructive nasal lesion mimicking ENKL. The differentiation between M marinum infection and ENKL is clinically important because misdirected treatment leads to a poor prognosis. NTM infections including M marinum should be considered in differential diagnosis of ENKL. Bacterial cultures, pathological analysis, and close monitoring are required for the differentiation of ENKL and disseminated M marinum infection; both are serious diseases and early diagnostic distinction between them and immediate appropriate treatment will improve the patient's prognosis.
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Affiliation(s)
- Takanori Asakura
- From the Divisions of Pulmonary Medicine (TA, MI, HN, ST, TB) and Hematology (TK, TS, SO), Department of Medicine; Division of Diagnostic Pathology (KK); and Center for Infectious Diseases and Infection Control (KS, NH), Keio University School of Medicine; Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases (NN, YH), Tokyo, Japan
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117
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Common and Dangerous Skin Infections. CURRENT DERMATOLOGY REPORTS 2016. [DOI: 10.1007/s13671-016-0128-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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