Ann Dermatol.  2014 Apr;26(2):236-240. 10.5021/ad.2014.26.2.236.

Soft Tissue Infection Caused by Rapid Growing Mycobacterium following Medical Procedures: Two Case Reports and Literature Review

• Lin SS
• Lee CC
• Jang TN

• KMID: 2171661
• DOI: http://doi.org/10.5021/ad.2014.26.2.236

Abstract

Non-tubecrulosis mycobacterium infections were increasingly reported either pulmonary or extrapulmonary in the past decades. In Taiwan, we noticed several reports about the soft tissue infections caused by rapid growing mycobacterium such as Mycobacterium abscessus, Mycobacterium chelonae, on newspaper, magazines, or the multimedia. Most of them occurred after a plastic surgery, and medical or non-medical procedures. Here, we reported two cases of these infections following medical procedures. We also discussed common features and the clinical course of the disease, the characteristics of the infected site, and the treatment strategy. The literatures were also reviewed, and the necessity of the treatment guidelines was discussed.

Keyword

Mycobacterium abscessus; Mycobacterium chelonae; Non-tuberculous mycobacteria; Rapid growing Mycobacterium; Soft tissue infections

MeSH Terms

Multimedia
Mycobacterium chelonae
Mycobacterium Infections
Mycobacterium*
Periodicals
Periodicals as Topic
Soft Tissue Infections*
Surgery, Plastic
Taiwan

Figure

• 

  Fig. 1 Frontal view of patient's face showed multiple erythematous lesions (arrows) over bilateral cheeks.

• 

  Fig. 2 Lateral view of patient's face showed sticky discharge (arrow) from the erythematous nodules.

• 

  Fig. 3 Multiple erythematous nodules were found over the dorsal side of hand.

• 

  Fig. 4 Photomicrograph shows histopathological findings from dorsum of hand of the patient. A granulomatous lesion with central abscess formation (arrow) and lymphohistiocytic and multinucleated giant cells infiltration were noted (H&E, ×100).

• 

  Fig. 5 Photomicrograph shows histopathological findings from dorsum of hand of the patient. Lymphocytes, epithelioid histiocytic and multinucleated giant cells (arrow) infiltration were noted (H&E, ×400).

• 

  Fig. 6 After 1 months of combined antibiotic therapy, the skin lesions of both hands showed almost complete resolution.

Reference

1. Wongkitisophon P, Rattanakaemakorn P, Tanrattanakorn S, Vachiramon V. Cutaneous mycobacterium abscessus infection associated with mesotherapy injection. Case Rep Dermatol. 2011; 3:37–41.

2. Uslan DZ, Kowalski TJ, Wengenack NL, Virk A, Wilson JW. Skin and soft tissue infections due to rapidly growing mycobacteria: comparison of clinical features, treatment, and susceptibility. Arch Dermatol. 2006; 142:1287–1292.

3. Toy BR, Frank PJ. Outbreak of Mycobacterium abscessus infection after soft tissue augmentation. Dermatol Surg. 2003; 29:971–973.

4. Sañudo A, Vallejo F, Sierra M, Hoyos JG, Yepes S, Wolff JC, et al. Nontuberculous mycobacteria infection after mesotherapy: preliminary report of 15 cases. Int J Dermatol. 2007; 46:649–653.

5. Garcia-Navarro X, Barnadas MA, Dalmau J, Coll P, Gurguí M, Alomar A. Mycobacterium abscessus infection secondary to mesotherapy. Clin Exp Dermatol. 2008; 33:658–659.

6. Guevara-Patiño A, Sandoval de Mora M, Farreras A, Rivera-Olivero I, Fermin D, de Waard JH. Soft tissue infection due to Mycobacterium fortuitum following acupuncture: a case report and review of the literature. J Infect Dev Ctries. 2010; 4:521–525.

7. Bechara C, Macheras E, Heym B, Pages A, Auffret N. Mycobacterium abscessus skin infection after tattooing: first case report and review of the literature. Dermatology. 2010; 221:1–4.

8. Bodle EE, Cunningham JA, Della-Latta P, Schluger NW, Saiman L. Epidemiology of nontuberculous mycobacteria in patients without HIV infection, New York City. Emerg Infect Dis. 2008; 14:390–396.

9. Henry MT, Inamdar L, O'Riordain D, Schweiger M, Watson JP. Nontuberculous mycobacteria in non-HIV patients: epidemiology, treatment and response. Eur Respir J. 2004; 23:741–746.

10. Wilson RW, Steingrube VA, Böttger EC, Springer B, Brown-Elliott BA, Vincent V, et al. Mycobacterium immunogenum sp. nov., a novel species related to Mycobacterium abscessus and associated with clinical disease, pseudo-outbreaks and contaminated metalworking fluids: an international cooperative study on mycobacterial taxonomy. Int J Syst Evol Microbiol. 2001; 51:1751–1764.

11. Zelazny AM, Root JM, Shea YR, Colombo RE, Shamputa IC, Stock F, et al. Cohort study of molecular identification and typing of Mycobacterium abscessus, Mycobacterium massiliense, and Mycobacterium bolletii. J Clin Microbiol. 2009; 47:1985–1995.

12. Chen HY, Chen CY, Huang CT, Ruan SY, Chou CH, Lai CC, et al. Skin and soft-tissue infection caused by non-tuberculous mycobacteria in Taiwan, 1997-2008. Epidemiol Infect. 2011; 139:121–129.