Cutaneous nontuberculous mycobacteria infections: A retrospective case series of 78 patients from the Texas Gulf Coast region
| Autor: | Bernard R Gibson, Michael J. Loeffelholz, Brent Kelly, Paige Hoyer, Rebecca C. Philips, Skyler M White, Katherine T. Tinkey, Clark R. Andersen, Michael G. Wilkerson |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.drug_class Antibiotics Mycobacterium Infections Nontuberculous Dermatology Mycobacterium abscessus Stain Young Adult 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Antibiotic resistance Risk Factors Drug Resistance Bacterial Humans Medicine Aged Retrospective Studies Skin Aged 80 and over Gulf of Mexico biology medicine.diagnostic_test business.industry Incidence Incidence (epidemiology) Nontuberculous Mycobacteria Skin Diseases Bacterial Environmental exposure Middle Aged bacterial infections and mycoses biology.organism_classification Texas Anti-Bacterial Agents 030220 oncology & carcinogenesis Skin biopsy Drug Therapy Combination Female Nontuberculous mycobacteria business |
| Zdroj: | Journal of the American Academy of Dermatology. 81:730-739 |
| ISSN: | 0190-9622 |
| Popis: | Background The incidence of cutaneous nontuberculous mycobacteria (NTM) infections is increasing. These infections are a diagnostic and therapeutic challenge. Objective We investigated the clinical features, diagnosis, and management of cutaneous NTM infections. Methods A retrospective case series studied 78 patients from a Gulf Coast tertiary referral center diagnosed with cutaneous NTM infection by culture or stain of a skin biopsy specimen. Results A history of trauma, procedure, or environmental exposure was common. The mean time between the initial evaluation and diagnosis was 12 weeks. Only 15% of acid-fast bacillus-positive cultures had a positive acid-fast bacillus smear, and only 43% of those accompanied by skin biopsy specimen had a positive Fite stain. Immunosuppressed patients were more likely to have a positive Fite stain. Treatment included surgery and multiple antibiotics. Immunosuppressed patients and Mycobacterium abscessus group infections were more likely to have persistent disease. Limitations M chelonae and M abscessus isolates were indistinguishable and therefore were reported together. Five cases were not confirmed by culture. Conclusions Even with clinical suspicion, the diagnosis of NTM infection can be difficult. Results of acid-fast bacillus smears and special stains are frequently negative. Antibiotic resistance is common. Multidrug treatment is often required, and surgical therapy may be needed. |
| Databáze: | OpenAIRE |
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