Suppurative Inflammation With Microabscess and Pseudocyst Formation Is a Characteristic Histologic Manifestation of Cutaneous Infections With Rapid-GrowingMycobacteriumSpecies
| Autor: | Derek K. Marsee, Scott R. Granter, Ashley D. Gable, Danny A. Milner |
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| Rok vydání: | 2008 |
| Předmět: |
Male
Pathology medicine.medical_specialty Anti-Inflammatory Agents Mycobacterium chelonae Context (language use) Mycobacterium abscessus Microbiology Immunocompromised Host medicine Humans Abscess Microabscess Immunodeficiency Aged Inflammation Mycobacterium Infections Suppuration biology Immunologic Deficiency Syndromes Histology Skin Diseases Bacterial General Medicine Middle Aged medicine.disease biology.organism_classification Rapid growing mycobacterium Prednisone Female |
| Zdroj: | American Journal of Clinical Pathology. 130:514-517 |
| ISSN: | 1943-7722 0002-9173 |
| DOI: | 10.1309/dpclawwqntb74jnb |
| Popis: | Mycobacterial infections of the skin classically cause a granulomatous tissue reaction. We have observed a suppurative pattern of inflammation associated with infections by rapid-growing Mycobacterium species in immunocompromised patients. We report 6 cases in skin and soft tissue with an unusual but consistent lack of a predominance of granulomatous inflammation. Of the 6 cases, 4 had predominantly (~75%) suppurative inflammation, 1 case predominantly demonstrated (~75%) a mix of acute and chronic inflammation, and 1 case showed an approximately equal contribution of suppurative and granulomatous inflammation. All 6 cases showed abscess formation and numerous acid-fast bacilli (AFB) on AFB stain and were confirmed by tissue culture. Of these 6 cases, 2 had microabscesses with central pseudocysts harboring microorganisms. Five patients were taking oral prednisone, and 1 had an uncharacterized immunodeficiency. These cases highlight the need for awareness of this unusual manifestation of infection with rapidgrowing Mycobacterium species, particularly in immunocompromised patients. Mycobacterial infections in the skin, as in other parts of the body, classically cause a granulomatous tissue reaction. Pathologists readily order acid-fast bacilli (AFB) stains, such as Kinyoun or Fite stain, along with fungal stains in the context of granulomatous inflammation. However, infection with AFB is often not considered in the differential diagnosis of prominent acute inflammation and abscess formation in skin and soft tissue. As a consequence, only Gram and fungal stains are often ordered in these cases. Herein, we describe suppurative response to infection with rapid-growing species of mycobacteria in immunocompromised patients. |
| Databáze: | OpenAIRE |
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