A Clinical, Microbiological, and Pathological Study of Cutaneous Nontuberculous Mycobacterial Infection.
- Author:
Min Soo JANG
1
;
Sang Hwa HAN
;
Sang Tae KIM
;
Kee Suck SUH
Author Information
1. Department of Dermatology, Kosin University College of Medicine, Busan, Korea. ksderm98@unitel.co.kr
- Publication Type:Original Article
- Keywords:
Mycobacterium marinum;
Nontuberculous mycobacteria
- MeSH:
Diagnosis;
Fibrosis;
Granuloma;
Histiocytes;
Humans;
Lipectomy;
Lymphocytes;
Medical Records;
Mycobacterium chelonae;
Mycobacterium fortuitum;
Mycobacterium marinum;
Mycobacterium ulcerans;
Neutrophils;
Nontuberculous Mycobacteria;
Panniculitis;
Polymerase Chain Reaction;
Triamcinolone
- From:Korean Journal of Dermatology
2014;52(1):26-33
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: As the immunocompromised population has increased in recent years, the number of cutaneous nontuberculous mycobacterial (NTM) infections has also risen. However, since this affliction has no pathognomonic clinical or histological features, the diagnosis and treatment of cutaneous NTM infections are often delayed. OBJECTIVE: The aim of this study was to investigate the microbiological, clinical, and histological findings of cutaneous NTM infections. METHODS: We reviewed medical records and histologic slides of 10 patients diagnosed with cutaneous NTM infections confirmed by culture or polymerase chain reaction. RESULTS: All patients except one were immunocompetent, and 5 of 10 patients had preceding factors including trauma, liposuction, and intralesional triamcinolone injection. Microbiologically, of the 10 infections, 5 were caused by Mycobacterium marinum, 3 by Mycobacterium fortuitum, and 1 each by Mycobacterium chelonae and Mycobacterium ulcerans, respectively. Of the 5 patients with M. marinum, 2 had a fish-related job and 1 reared fish at a home aquarium. The most common clinical presentation was erythematous nodules (7/10). Histologically, irregular acanthosis (4/10), mixed cell infiltrate of lymphocytes, histiocytes, neutrophils (9/10), suppurative granuloma (7/10), microcysts lined by neutrophils (5/10), fibrosis (4/10), and panniculitis (7/10) were identified. CONCLUSION: We found microcysts lined by neutrophils in 50% of the samples and considered this finding to be a diagnostic marker of NTM infection. These clinicopathologic features will assist clinicians in diagnosing NTM infection more rapidly and accurately.
