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Sun Y, Li H. Mycobacterium haemophilum infection in immunocompetent adults: a literature review and case report. Int J Dermatol 2024; 63:169-176. [PMID: 38058233 DOI: 10.1111/ijd.16874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 09/14/2023] [Accepted: 09/28/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Mycobacterium haemophilum has been increasingly found in severely immunocompromised patients but is scarcely reported in immunocompetent adults. METHODS We systematically reviewed previous literature to identify studies on infection in immunocompetent adults. Articles reporting at least one case of M. haemophilum infection were included. We excluded articles involving patients who had immunosuppression-related diseases and routinely used glucocorticoids or immunosuppressants. We also reported a case of a young immunocompetent woman infected by M. haemophilum along the eyebrows, which was probably due to the use of an eyebrow pencil retrieved from a sink drain. RESULTS Twelve qualifying articles reporting M. haemophilum infection in immunocompetent adults were identified. Among them, most cases report skin lesions along the eyebrows, and the remaining had cervicofacial lymphadenitis, lesions on the arm or fingers, inflammation in the eyeballs, or ulceration in the perineal region. Most cases were caused by tattoos, make-up, injury, or surgical operation. For diagnosis, specialized tissue culture sensitivity was roughly 75%, and polymerase chain reaction (PCR) test sensitivity was approximately 89%. Triple antibiotic therapy for 3 to 24 months, or surgical excision was effective in controlling infection. CONCLUSION M. haemophilum infection should be considered if routine antibacterial and glucocorticoid treatments are ineffective against the disease, even in healthy adults. To definitively diagnose this infection, conditioned tissue culture or PCR testing is required. Treatment usually involves a combination of multiple antibiotics and, if necessary, surgical removal of infected tissue.
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Affiliation(s)
- Yuan Sun
- Department of Ophthalmology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Huiyan Li
- Department of Ophthalmology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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Das S, Murthy SI, Padhi TR, Behera HS, Jakati S, Sharma S, Das S. Ocular infections associated with atypical mycobacteria: A review. Indian J Ophthalmol 2024; 72:19-28. [PMID: 38131566 PMCID: PMC10841776 DOI: 10.4103/ijo.ijo_560_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 07/20/2023] [Accepted: 08/04/2023] [Indexed: 12/23/2023] Open
Abstract
Atypical mycobacteria or non-tuberculous mycobacteria (NTM) are a group of acid-fast bacteria that are pathogenic to different parts of the eye. The organisms can cause a spectrum of ocular infections including keratitis, scleritis, uveitis, endophthalmitis and orbital cellulitis. Trauma, whether surgical or nonsurgical, has the highest correlation with development of this infection. Common surgeries after which these infections have been reported include laser in situ keratomileusis (LASIK) and scleral buckle surgery. The organism is noted to form biofilms with sequestration of the microbe at different inaccessible locations leading to high virulence. Collection of infective ocular material (corneal scraping/necrotic scleral tissue/abscess material/vitreous aspirate, etc.) and laboratory identification of the organism through microbiologic testing are vital for confirming presence of the infection and initiating treatment. In cluster infections, tracing the source of infection in the hospital setting via testing of different in-house samples is equally important to prevent further occurrences. Although the incidence of these infections is low, their presence can cause prolonged disease that may often be resistant to medical therapy alone. In this review, we describe the various types of NTM-ocular infections, their clinical presentation, laboratory diagnosis, management, and outcomes.
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Affiliation(s)
- Shilpa Das
- Cornea Service, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Somasheila I Murthy
- Cornea and Anterior Segment Service, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Tapas Ranjan Padhi
- Vitreo Retinal Service, L V Prasad Eye Institute, Bhubaneswar, Odisha, India
| | | | - Saumya Jakati
- Ophthalmic Pathology Laboratory, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Savitri Sharma
- Jhaveri Microbiology Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sujata Das
- Cornea and Anterior Segment Service, L V Prasad Eye Institute, Bhubaneswar, Odisha, India
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Zhang YQ, Xu TT, Wang FY, Wang S, Cheng J. Ocular Mycobacterium haemophilum infection originating in the cornea: a case report. BMC Infect Dis 2023; 23:140. [PMID: 36882753 PMCID: PMC9993689 DOI: 10.1186/s12879-023-08094-2] [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: 08/30/2022] [Accepted: 02/16/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Mycobacterium haemophilum is a slow-growing non-chromogenic nontuberculous Mycobacterium species that can cause skin infection or arthritis in an immunocompromised population or in children. Primary infection of the healthy adult cornea is rare. The special requirements for culture make this pathogen difficult to diagnose. The study aims to report the clinical manifestation and treatment process of corneal infection and notify the awareness of M. Haemophilus keratitis among clinicians. This is the first case report of primary M. haemophilum infection in the cornea of healthy adults reported in the literature. CASE PRESENTATION A 53-year-old healthy goldminer presented with left eye redness and a history of vision loss for four months. The patient was misdiagnosed with herpes simplex keratitis until M. haemophilum was detected using high-throughput sequencing. Penetrating keratoplasty was performed, and a large number of mycobacteria were detected by Ziehl-Neelsen staining of the infected tissue. Three months later, the patient developed conjunctival and eyelid skin infections that manifested as caseous necrosis of the conjunctiva and skin nodules. After excision and debridement of the conjunctival lesions and systemic antituberculosis drug treatment for 10 months, the patient was cured. CONCLUSION M. haemophilum could cause primary corneal infection in healthy adults, which is an infrequent or rare infection. Owing to the need for special bacterial culture conditions, conventional culture methods do not provide positive results. High-throughput sequencing can rapidly identify the presence of bacteria, which aids in early diagnosis and timely treatment. Prompt surgical intervention is an effective treatment option for severe keratitis. Long-term systemic antimicrobial therapy is crucial.
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Affiliation(s)
- Yu-Qiang Zhang
- Qingdao University, Qingdao, China.,Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China.,School of Ophthalmology, Shandong First Medical University, Qingdao, China.,Anqiu People's Hospital, Weifang, China
| | - Ting-Ting Xu
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China.,School of Ophthalmology, Shandong First Medical University, Qingdao, China.,Institute of Clinical Medicine, Weifang Medical University, No. 7166 Baotong West Street, Weifang, China
| | - Fu-Yan Wang
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, China.,School of Ophthalmology, Shandong First Medical University, Qingdao, China
| | - Shuang Wang
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, China.,School of Ophthalmology, Shandong First Medical University, Qingdao, China
| | - Jun Cheng
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China. .,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, China. .,School of Ophthalmology, Shandong First Medical University, Qingdao, China. .,Shandong Eye Institute, 5 Yanerdao Road, Qingdao, 266071, China.
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Chen X, Lv X, Yang L, Bai F, Liu X. Etiology, Pathogens, Clinical Features and Treatment of Bacterial Scleritis. Semin Ophthalmol 2023:1-8. [PMID: 36794923 DOI: 10.1080/08820538.2023.2177117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
We retrospectively reviewed literature reports on pathogens, clinical features, diagnosis, treatment, and clinical and visual outcomes in patients with bacterial scleritis over the past decade. Eye surgery and trauma are the most common causes of bacterial infections. Subtenon triamcinolone acetonide injection, intravitreal ranibizumab, and wearing contact lenses are also causes of bacterial scleritis. Pseudomonas aeruginosa is the most common pathogenic microorganism causing bacterial scleritis. Mycobacterium tuberculosis ranks second. The main symptoms of bacterial scleritis are red and painful eyes. The patient's visual acuity decreased significantly. Bacterial scleritis caused by Pseudomonas aeruginosa often manifests as necrotizing scleritis, tuberculous scleritis and syphilitic scleritis are mostly nodular scleritis. Bacterial scleritis often involves the cornea, and approximately 37.6% (32 eyes) of patients had corneal bacterial infection. Hyphema was present in 18.8% (16 eyes). Elevated intraocular pressure was observed in 36.5% (31 eyes) of patients. Bacterial culture was an effective method of diagnosis. Most bacterial scleritis cases require both aggressive medical and surgical treatment, and the drug choice must be based on antibiotic susceptibility testing.
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Affiliation(s)
- Xiangtong Chen
- Ophthalmologic Center of the Second Hospital, Jilin University, Changchun, P.R. China.,Clinical College, Jilin University, Changchun, P.R. China
| | - Xueman Lv
- Department of Ophthalmology, China-Japan Union Hospital of Jilin University, Changchun, P.R. China
| | - Li Yang
- Ophthalmologic Center of the Second Hospital, Jilin University, Changchun, P.R. China
| | - Feng Bai
- Ophthalmologic Center of the Second Hospital, Jilin University, Changchun, P.R. China
| | - Xiaoli Liu
- Ophthalmologic Center of the Second Hospital, Jilin University, Changchun, P.R. China
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Harder S, Oberholtzer S, Shumilak G, Wudel B. Disseminated cutaneous Mycobacterium haemophilum infection in a patient on infliximab for rheumatoid arthritis. BMJ Case Rep 2022; 15:e245853. [PMID: 35039354 PMCID: PMC8768494 DOI: 10.1136/bcr-2021-245853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2021] [Indexed: 11/04/2022] Open
Abstract
Mycobacterium haemophilum is a rarely encountered pathogen that is difficult to identify given its unique growth requirements. It is most often seen in adult patients who are immunosuppressed due to advanced HIV or haematological malignancy. Our case highlights a typical presentation of an atypical pathogen in a patient with rheumatoid arthritis receiving anti-tumour necrosis factor therapy. This case represents an important patient population in whom this previously rare infection is increasingly common.
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Affiliation(s)
- Samuel Harder
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Sarah Oberholtzer
- Department of Medicine, Saskatchewan Health Authority, Saskatoon, Saskatchewan, Canada
| | - Geoffrey Shumilak
- Department of Medicine, Saskatchewan Health Authority, Saskatoon, Saskatchewan, Canada
| | - Beverly Wudel
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- Department of Medicine, Saskatchewan Health Authority, Saskatoon, Saskatchewan, Canada
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Chen ZY, Kuo CT, Chen YT, Tsai IL, Tsai CY. Orbital and conjunctival nontuberculous mycobacteria infection. Taiwan J Ophthalmol 2022. [DOI: 10.4103/2211-5056.354534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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