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Fujimori T, Hagiya H, Iio K, Yamasaki O, Miyamoto Y, Hoshino Y, Kakehi A, Okura M, Minabe H, Yokoyama Y, Otsuka F, Higashikage A. Buruli ulcer caused by Mycobacterium ulcerans subsp. shinshuense: A case report. J Infect Chemother 2023; 29:523-526. [PMID: 36813163 DOI: 10.1016/j.jiac.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 01/19/2023] [Accepted: 02/20/2023] [Indexed: 02/23/2023]
Abstract
Buruli ulcer is the third most common mycobacterial infection worldwide and is mainly diagnosed in tropical regions. Globally, this progressive disease is caused by Mycobacterium ulcerans; however, Mycobacterium ulcerans subsp. shinshuense, an Asian variant, has been exclusively identified in Japan. Because of insufficient clinical cases, the clinical features of M. ulcerans subsp. shinshuense-associated Buruli ulcer remain unclear. A 70-year-old Japanese woman presented with erythema on her left backhand. The skin lesion deteriorated without an apparent etiology of inflammation, and she was referred to our hospital 3 months after disease onset. A biopsy specimen was incubated in 2% Ogawa medium at 30 °C. After 66 days, we detected small yellow-pigmented colonies, suggesting scotochromogens. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI Biotyper; Bruker Daltonics, Billerica, MA, USA) indicated that the organism was Mycobacterium pseudoshottsii or Mycobacterium marinum. However, additional PCR testing for the insertion sequence 2404 (IS2404) was positive, suggesting that the pathogen was either M. ulcerans or M. ulcerans subsp. shinshuense. Further examination by 16S rRNA sequencing analysis, focusing on nucleotide positions 492, 1247, 1288, and 1449-1451, we finally identified the organism as M. ulcerans subsp. shinshuense. The patient was successfully treated with 12 weeks of clarithromycin and levofloxacin treatment. Mass spectrometry is the latest microbial diagnostic method; however, it cannot be used to identify M. ulcerans subsp. shinshuense. To accurately detect this enigmatic pathogen and uncover its epidemiology and clinical characteristics in Japan, more accumulation of clinical cases with accurate identification of the causative pathogen is essential.
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Affiliation(s)
- Takumi Fujimori
- Microbiology Division, Clinical Laboratory, Okayama University Hospital, Okayama, 700-8558, Japan.
| | - Hideharu Hagiya
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan.
| | - Koji Iio
- Microbiology Division, Clinical Laboratory, Okayama University Hospital, Okayama, 700-8558, Japan.
| | - Osamu Yamasaki
- Department of Dermatology, Shimane University Faculty of Medicine, Shimane, 693-8501, Japan.
| | - Yuji Miyamoto
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, 189-0002, Japan.
| | - Yoshihiko Hoshino
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, 189-0002, Japan.
| | - Ayaka Kakehi
- Microbiology Division, Clinical Laboratory, Okayama University Hospital, Okayama, 700-8558, Japan.
| | - Mami Okura
- Microbiology Division, Clinical Laboratory, Okayama University Hospital, Okayama, 700-8558, Japan.
| | - Hiroshi Minabe
- Microbiology Division, Clinical Laboratory, Okayama University Hospital, Okayama, 700-8558, Japan.
| | - Yukika Yokoyama
- Microbiology Division, Clinical Laboratory, Okayama University Hospital, Okayama, 700-8558, Japan.
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan.
| | - Akihito Higashikage
- Microbiology Division, Clinical Laboratory, Okayama University Hospital, Okayama, 700-8558, Japan.
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Gyamfi E, Dogbe MA, Quaye C, Affouda AA, Kyei-Baffour E, Awuku-Asante D, Sarpong-Duah M, Mosi L. Variable Number Tandem Repeat Profiling of Mycobacterium ulcerans Reveals New Genotypes in Buruli Ulcer Endemic Communities in Ghana and Côte d’Ivoire. Front Microbiol 2022; 13:872579. [PMID: 35814673 PMCID: PMC9262091 DOI: 10.3389/fmicb.2022.872579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/27/2022] [Indexed: 11/13/2022] Open
Abstract
Buruli ulcer (BU), a necrotic skin disease caused by Mycobacterium ulcerans, is mainly prevalent in West Africa, but cases have also been reported in other tropical parts of the world. It is the second most common mycobacterial disease after tuberculosis in Ghana and Côte d’Ivoire. Heterogeneity among M. ulcerans from different geographical locations has not been clearly elucidated, and some studies seem to suggest genetic differences between M. ulcerans in humans and in the environment. This study aimed at identifying genetic differences among M. ulcerans strains between two BU endemic countries: Ghana and Côte d’Ivoire. Clinical samples consisting of swabs, fine needle aspirates, and tissue biopsies of suspected BU lesions and environmental samples (e.g., water, biofilms from plants, soil, and detrital material) were analyzed. BU cases were confirmed via acid fast staining and PCR targeting the 16S rRNA, IS2404, IS2606, and ER domain genes present on M. ulcerans. Heterogeneity among M. ulcerans was determined through VNTR profiling targeting 10 loci. Eleven M. ulcerans genotypes were identified within the clinical samples in both Ghana and Côte d’Ivoire, whiles six M. ulcerans genotypes were found among the environmental samples. Clinical M. ulcerans genotypes C, D, F, and G were common in both countries. Genotype E was unique among the Ghanaian samples, whiles genotypes A, Z, J, and K were unique to the Ivorian samples. Environmental isolates were found to be more conserved compared with the clinical isolates. Genotype W was observed only among the Ghanaian environmental samples. Genotype D was found to be prominent in both clinical and environmental samples, suggesting evidence of possible transmission of M. ulcerans from the environment, particularly water bodies and biofilms from aquatic plants, to humans through open lesions on the skin.
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Choi H, Kim YI, Na CH, Kim MS, Shin BS. Mycobacterium abscessus Skin Infection Associated with Shaving Activity in a 75-year-old Man. Ann Geriatr Med Res 2018; 22:204-207. [PMID: 32743275 PMCID: PMC7387629 DOI: 10.4235/agmr.18.0034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 11/04/2018] [Accepted: 11/05/2018] [Indexed: 01/15/2023] Open
Abstract
Mycobacterium abscessus comprises rapidly growing mycobacteria, and the clinical manifestations of M. abscessus skin infection include papule, nodule, ulcer, scar and mixed form. The cutaneous infections have been reported due to minor trauma, cosmetic therapy, acupuncture and disseminated infection. A 75-year-old man presented with pruritic diffuse various sized erythematous papuloplaques and pustules on the neck and chest for 2 months. The cutaneous lesions were spread around the wound of the shaving on the neck. The histopathologic findings were consistent with abscess showing infiltrations of neutrophils and lymphocytes in the dermis and negative findings were observed on immunohistochemical stain including acid-fast bacilli stain. One month later, mycobacterial culture result showed positive findings, and the pathogen was identified by reverse-transcriptase polymerase chain reaction with hybridization. The patient was treated with combination of clarithromycin and ethambutol for 5 months and there is no evidence of recurrence after 6 months of follow-up. Herein, we report a case of M. abscessus cutaneous infection through minor trauma caused by shaving in the elderly.
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Affiliation(s)
- Hoon Choi
- Department of Dermatology, Chosun University of Medicine, Gwangju, Korea
| | - Yong Il Kim
- Department of Dermatology, Chosun University of Medicine, Gwangju, Korea
| | - Chan Ho Na
- Department of Dermatology, Chosun University of Medicine, Gwangju, Korea
| | - Min Sung Kim
- Department of Dermatology, Chosun University of Medicine, Gwangju, Korea
| | - Bong Seok Shin
- Department of Dermatology, Chosun University of Medicine, Gwangju, Korea
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Nakanaga K, Ogura Y, Toyoda A, Yoshida M, Fukano H, Fujiwara N, Miyamoto Y, Nakata N, Kazumi Y, Maeda S, Ooka T, Goto M, Tanigawa K, Mitarai S, Suzuki K, Ishii N, Ato M, Hayashi T, Hoshino Y. Naturally occurring a loss of a giant plasmid from Mycobacterium ulcerans subsp. shinshuense makes it non-pathogenic. Sci Rep 2018; 8:8218. [PMID: 29844323 PMCID: PMC5974349 DOI: 10.1038/s41598-018-26425-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 04/30/2018] [Indexed: 12/30/2022] Open
Abstract
Mycobacterium ulcerans is the causative agent of Buruli ulcer (BU), a WHO-defined neglected tropical disease. All Japanese BU causative isolates have shown distinct differences from the prototype and are categorized as M. ulcerans subspecies shinshuense. During repeated sub-culture, we found that some M. shinshuense colonies were non-pigmented whereas others were pigmented. Whole genome sequence analysis revealed that non-pigmented colonies did not harbor a giant plasmid, which encodes elements needed for mycolactone toxin biosynthesis. Moreover, mycolactone was not detected in sterile filtrates of non-pigmented colonies. Mice inoculated with suspensions of pigmented colonies died within 5 weeks whereas those infected with suspensions of non-pigmented colonies had significantly prolonged survival (>8 weeks). This study suggests that mycolactone is a critical M. shinshuense virulence factor and that the lack of a mycolactone-producing giant plasmid makes the strain non-pathogenic. We made an avirulent mycolactone-deletion mutant strain directly from the virulent original.
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Affiliation(s)
- Kazue Nakanaga
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yoshitoshi Ogura
- Department of Bacteriology, Faculty of Medicine, Kyushu University, Fukuoka, Japan
| | - Atsushi Toyoda
- Center for Information Biology, National Institute of Genetics, Shizuoka, Japan
| | - Mitsunori Yoshida
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hanako Fukano
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Nagatoshi Fujiwara
- Department of Food and Nutrition, Faculty of Contemporary Human Life Science, Tezukayama University, Nara, Japan
| | - Yuji Miyamoto
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Noboru Nakata
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yuko Kazumi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
- The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Shinji Maeda
- The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
- School of Pharmacy, Hokkaido Pharmaceutical University, Sapporo, Japan
| | - Tadasuke Ooka
- Department of Microbiology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | | | - Kazunari Tanigawa
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
- Faculty of Pharma-Sciences, Teikyo University, Tokyo, Japan
| | - Satoshi Mitarai
- The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Koichi Suzuki
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
- Department of Clinical Laboratory Science, Faculty of Medical Technology, Teikyo University, Tokyo, Japan
| | - Norihisa Ishii
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Manabu Ato
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tetsuya Hayashi
- Department of Bacteriology, Faculty of Medicine, Kyushu University, Fukuoka, Japan
| | - Yoshihiko Hoshino
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
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Abstract
Central nervous system (CNS) disease caused by Mycobacterium tuberculosis (MTB) is highly devastating. Tuberculous meningitis (TBM) is the most common form of CNS tuberculosis (TB). Rapid, sensitive, and affordable diagnostic tests are not available. Ziehl-Neelsen (ZN) stain has a very low sensitivity in cases of TBM, the sensitivity rates is of about 10-20%.The detection rate can be improved by taking large volume CSF samples (>6 ml) and prolonged slide examination (30 min). Culture of MTB from the CSF is slow and insufficiently sensitive. The sensitivity is different, which varies from 36% to 81.8%. The microscopic observation drug susceptibility (MODS) assay was recommended by the World Health Organization in 2011. The sensitivity is 65%, which is more sensitive and faster than CSF smear. Commercial PCR assays were found to be insensitive at detecting MTB in CSF samples. Many research provided the value of ADA on the TBM diagnosis. Interferon-gamma release assays (IGRAs) are not recommended for diagnosis of active TB disease. Imaging is essential in diagnosis and showing complications of CNS TB. Thwaites criteria and the Lancet consensus scoring system (LCSS) were developed to improve the diagnosis of TBM. Clinicians will continue to make judgment based on clinical examination, inflammatory CSF examinations, imaging studies, and scoring systems.
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Affiliation(s)
- Yi-Yi Wang
- Department of Neurology, Tianjin Haihe Hospital, Tianjin, P.R. China.
| | - Bing-di Xie
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, P.R. China
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Nishikawa R, Yamada Y, Kanki H, Matsuoka H, Nakamura T, Jikimoto T, Kusuki M, Ishii N, Ohnuma K, Nakanaga K, Nishigori C. Case of Mycobacterium haemophilum misdiagnosed as Mycobacterium intracellulare due to one base insertion in the bacterial genome. J Dermatol 2017; 45:64-66. [PMID: 28771786 DOI: 10.1111/1346-8138.13988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 06/25/2017] [Indexed: 11/28/2022]
Abstract
Mycobacterium haemophilum is a slow-growing, non-tuberculous mycobacteria that causes cutaneous infection. We describe a case of cutaneous infection in a 68-year-old Japanese man with polymyositis. This was caused by M. haemophilum harboring one base insertion in gene sequence. At first, the causal microorganism was misidentified as M. intracellulare by COBAS® TaqMan® MAI test. However, poor growth on Ogawa media and growth enhancement on 7H11C agar around a hemin-containing disk prompted us to reinvestigate the causal microorganisms, which were revealed to be M. haemophilum. Amplified polymerase chain reaction products were sequenced, and the 16S rRNA gene, rpoB, hsp65 and internal transcribed spacer region sequences showed a 100%, 100%, 99.66% and 99.7% match, respectively, with the corresponding regions of M. haemophilum, but it harbored a novel gene sequence in hsp65. The sequences determined by gene analysis of the M. haemophilum strain were deposited into the International Nucleotide Sequence Database. Although numerous cases of M. haemophilum infection have been reported in other countries, only six cases have been reported in Japan to date. It could be possible that this novel mutation lead to misdiagnosis. As M. haemophilum prefers a lower growth temperature (30-32°C) and it requires iron in the culture medium, M. haemophilum could be misidentified or overlooked. Accordingly, a M. haemophilum infection should be considered in cases of cutaneous infection of the body sites, of which surface temperature is low.
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Affiliation(s)
- Rika Nishikawa
- Dermatology, Department of Internal Related, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yozo Yamada
- Dermatology, Department of Internal Related, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Haruhisa Kanki
- Dermatology, Department of Internal Related, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroshi Matsuoka
- Division of Oncology/Hematology, Department of Internal Medicine, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tatsuya Nakamura
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Takumi Jikimoto
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Mari Kusuki
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Norihisa Ishii
- Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kenichiro Ohnuma
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Kazue Nakanaga
- Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Chikako Nishigori
- Dermatology, Department of Internal Related, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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Hwang S, Lee JH, Kim TY. Case of abscess caused by Mycobacterium massiliense associated with swimming. J Dermatol 2016; 44:470-471. [PMID: 27265426 DOI: 10.1111/1346-8138.13482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Sewon Hwang
- Department of Dermatology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji Hyun Lee
- Department of Dermatology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Tae Yoon Kim
- Department of Dermatology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Pescitelli L, Galeone M, Tripo L, Prignano F. Cutaneous Non-Tuberculous Mycobacterial Infections: Clinical Clues and Treatment Options. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2015. [DOI: 10.1007/s40506-015-0064-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Hoshino Y, Suzuki K. Differential diagnostic assays for discriminating mycobacteria, especially for nontuberculous mycobacteria: what does the future hold? Future Microbiol 2015; 10:205-16. [PMID: 25689533 DOI: 10.2217/fmb.14.120] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Mycobacteria infections are an important medical problem, and many are regarded as emerging and re-emerging diseases. Mycobacterium tuberculosis, the causative agent of tuberculosis, remains a leading cause of human morbidity and mortality worldwide, with approximately 8.6 million cases and 1.3 million deaths in 2012. In addition, the incidence of nontuberculous Mycobacterium infection has significantly increased, especially among developed countries. Although phenotypical appearances such as culture characteristics and/or susceptibility to anti-Mycobacterium drugs are variable between different mycobacterial species, early diagnosis is crucial in terms of patient treatment and clinical outcome. In this manuscript, we describe the development of diagnostic techniques, from the classical/conventional to the most recent advances, and provide an overview of the future direction of discrimination procedures.
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Affiliation(s)
- Yoshihiko Hoshino
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, 4-2-1 Aoba, Higashi-Murayama, Tokyo, Japan
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Ishii K, Ishii N, Nakanaga K, Nakano K, Saito I, Asahina A. Mycobacterium haemophilum infection with prominent facial manifestation mimicking leprosy. J Dermatol 2015; 42:992-5. [PMID: 26017241 DOI: 10.1111/1346-8138.12948] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 04/06/2015] [Indexed: 12/01/2022]
Abstract
Mycobacterium haemophilum is a slow-growing non-tuberculous mycobacterium that is rarely known to cause human skin infection, particularly in immunocompromised patients. We recently experienced a 69-year-old Japanese woman with this infection who had been under immunosuppressive treatment for recalcitrant rheumatoid arthritis. The patient showed disseminated erythematous plaques and subcutaneous nodules on the face and extremities, and interestingly, the face manifested with a striking "facies leontina" appearance. Biopsy revealed abscess and granulomatous dermatitis with the involvement of peripheral nerve bundles and the presence of innumerable acid-fast bacilli, thus necessitating differentiation from lepromatous leprosy. M. haemophilum was identified by molecular characterization as well as by successful culture with iron supplements. Although drug susceptibility testing indicated responsiveness to multiple antibiotics administrated simultaneously for the treatment, it took over 6 months to achieve significant improvement, and we also employed concurrent oral potassium iodide administration and repeated surgical excision. This case highlights the importance of continuous combination therapy for successful outcome in this rare infection. Furthermore, application of potassium iodide for mycobacterial infection warrants further evaluation by accumulating more cases.
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Affiliation(s)
- Kentaro Ishii
- Department of Dermatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Norihisa Ishii
- Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazue Nakanaga
- Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazuaki Nakano
- Department of Clinical Laboratory, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Ikuo Saito
- Department of Pathology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Akihiko Asahina
- Department of Dermatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.,Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
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Enomoto Y, Oba M, Ishii N, Nakanaga K, Yagi Y, Hasegawa H, Ozawa Y, Matsui T, Yokomura K, Suda T. Rhinosinusitis and disseminated cutaneous infection caused by Mycobacterium chelonae in an immunocompromised patient. J Infect Chemother 2015; 21:691-4. [PMID: 26025682 DOI: 10.1016/j.jiac.2015.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 03/20/2015] [Accepted: 04/24/2015] [Indexed: 11/28/2022]
Abstract
Mycobacterium chelonae frequently involves the skin, and the disseminated form can be observed in immunocompromised patients. In contrast, rhinosinusitis caused by the bacterium is a rare manifestation, which occurs independently of immune status. We report here a rare case of M. chelonae infection presenting as both disseminated cutaneous infection and rhinosinusitis in an immunocompromised patient. He had received systemic corticosteroids for 11 months due to cryptogenic organizing pneumonia. Before admission, he sustained injuries to his left arm and hand; those injuries succumbed to an infection that would subsequently spread to his other limbs, face, and even nasal cavities. This valuable case suggests that disseminated cutaneous infection by M. chelonae could spread to other organs.
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Affiliation(s)
- Yasunori Enomoto
- Department of Respiratory Medicine, Respiratory Disease Center, Seirei Mikatahara General Hospital, Japan; Second Department of Internal Medicine, Hamamatsu University School of Medicine, Japan.
| | - Misao Oba
- Department of Dermatology, Seirei Mikatahara General Hospital, Japan
| | - Norihisa Ishii
- Leprosy Research Center, National Institute of Infectious Diseases, Japan
| | - Kazue Nakanaga
- Leprosy Research Center, National Institute of Infectious Diseases, Japan
| | - Yuki Yagi
- Department of Otorhinolaryngology, Seirei Mikatahara General Hospital, Japan
| | - Hirotsugu Hasegawa
- Department of Respiratory Medicine, Respiratory Disease Center, Seirei Mikatahara General Hospital, Japan
| | - Yuichi Ozawa
- Department of Respiratory Medicine, Respiratory Disease Center, Seirei Mikatahara General Hospital, Japan
| | - Takashi Matsui
- Department of Respiratory Medicine, Respiratory Disease Center, Seirei Mikatahara General Hospital, Japan
| | - Koshi Yokomura
- Department of Respiratory Medicine, Respiratory Disease Center, Seirei Mikatahara General Hospital, Japan
| | - Takafumi Suda
- Second Department of Internal Medicine, Hamamatsu University School of Medicine, Japan
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12
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El-Khalawany MA. Atypical mycobacterial cutaneous infections in Egyptians: A clinicopathological study. J Dermatol 2014; 41:303-10. [DOI: 10.1111/1346-8138.12391] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Accepted: 12/09/2013] [Indexed: 12/20/2022]
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13
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Muramatsu K, Nomura T, Ito T, Hamade Y, Hirata Y, Fujita Y, Abe R, Shimizu H. Repeated skin sampling and prolonged incubation period identified cutaneous
M
ycobacterium chelonae
infection on the face in an immunocompetent man. Br J Dermatol 2014; 170:471-3. [DOI: 10.1111/bjd.12638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- K. Muramatsu
- Department of Dermatology Hokkaido University Graduate School of Medicine Sapporo Japan
| | - T. Nomura
- Department of Dermatology Hokkaido University Graduate School of Medicine Sapporo Japan
| | - T. Ito
- Department of Dermatology Hokkaido University Graduate School of Medicine Sapporo Japan
| | - Y. Hamade
- Department of Dermatology Hokkaido University Graduate School of Medicine Sapporo Japan
| | - Y. Hirata
- Department of Dermatology Hokkaido University Graduate School of Medicine Sapporo Japan
| | - Y. Fujita
- Department of Dermatology Hokkaido University Graduate School of Medicine Sapporo Japan
| | - R. Abe
- Department of Dermatology Hokkaido University Graduate School of Medicine Sapporo Japan
| | - H. Shimizu
- Department of Dermatology Hokkaido University Graduate School of Medicine Sapporo Japan
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14
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Chany AC, Tresse C, Casarotto V, Blanchard N. History, biology and chemistry of Mycobacterium ulcerans infections (Buruli ulcer disease). Nat Prod Rep 2014; 30:1527-67. [PMID: 24178858 DOI: 10.1039/c3np70068b] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Mycobacterium ulcerans infections (Buruli ulcer disease) have a long history that can be traced back 150 years. The successive discoveries of the mycobacteria in 1948 and of mycolactone A/B in 1999, the toxin responsible for this dramatic necrotic skin disease, resulted in a paradigm shift concerning the disease itself and in a broader sense, delineated an entirely new role for bioactive polyketides as virulence factors. The fascinating history, biology and chemistry of M. ulcerans infections are discussed in this review.
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Affiliation(s)
- Anne-Caroline Chany
- Université de Haute Alsace, Laboratoire de Chimie Organique et Bioorganique, EA4566, Ecole Nationale Supérieure de Chimie de Mulhouse, 3 rue Alfred Werner, 68093 Mulhouse Cedex, France
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