Background In January 2012, on the basis of an initial report from a dermatologist, we began to investigate an outbreak of tattoo-associated Mycobacterium chelonae skin and soft-tissue infections … BU often presents as a painless nodule, as a large indurated plaque, or as diffuse painless swelling of the lower extremities, upper extremities, or face (109). Skin infections may clear up without treatment. He is Professor of Medicine and Veterinary Medicine and Director of Scientific Research of the Faculty of Health Sciences of the Universidad Tecnológica de Pereira (UTP) in Pereira, Risaralda, Colombia. Alternatively, a combination of rifampin and clarithromycin or rifampin and moxifloxacin could be used (109, 112). Many of these new patients already have grade 2 neurological disability by the time of their diagnosis (96, 97). NTM infections of the skin may spread to cause tenosynovitis, myositis, osteomyelitis, and septic arthritis (24, 42, 117). The treatment for cutaneous mycobacterial infections depends on the specific pathogen and therefore requires a careful consideration of antimicrobial choices based on official treatment guidelines. They share phenotypic and genotypic features, including the large virulence plasmid (pMUM) required for mycolactone production. Molecular assays are useful in some cases. Rapidly Growing MycobacteriaCutaneous NTM infections are transmitted via direct inoculation through skin barrier breaks, which may occur during trauma, surgical procedures, plastic surgery (including liposuction), injections, tattoos, acupuncture, and body piercings (Table 4) (1, 24, 42, 117). Recognise possible cutaneous myobacterial infections; Introduction. Currently, the NTM group is also divided into two major subgroups defined by their ability to grow on solid culture media: (i) rapidly growing mycobacteria (RGM) and (ii) slowly growing mycobacteria (SGM) (Fig. Mycobacterium marinumM. Thank you for sharing this Clinical Microbiology Reviews article. His current research activities include the epidemiology and clinical spectrum of leprosy and other cutaneous mycobacterial diseases. Collectively, these bacteria constitute the group of mycolactone producers, including Mycobacterium shinshuense (identified in human cases in Japan), Mycobacterium pseudoshottsii (found in striped bass in the United States), M. marinum DL240490 (found in European sea bass in the Red Sea), and others (111, 113). The most common sites of involvement are the neck, axillae, or groin (Fig. Similarly, acute military tuberculosis represents primary infection in individuals with advanced immunosuppression, including those with HIV infection/AIDS (71). Mycobacterium abscessus was first identified in a patient with a knee infection and subcutaneous abscesses in 1950 (117). Clinical studies need to determine whether differences between infection with M. leprae and M. lepromatosis are clinically distinguishable (102, 107, 108) or whether coinfection with M. leprae and M. lepromatosis may potentially predispose individuals to experience more severe leprosy reactions (108). (Glasg), F.A.C.E, Ph.D.(c), Hon.D.Sc, is an expert in tropical diseases, particularly in zoonotic and vector-borne diseases, but also including tuberculosis and mycobacterial diseases. Relapse or reinfection is considered a rare clinical phenomenon (47, 78, 86, 87). Nontuberculous Mycobacteria: Skin and Soft Tissue Infections. In 1947, Mycobacterium ulcerans was identified as the cause of Buruli ulcer (BU) (2, 3, 31, 32, 109–111). In addition, some mycobacterial infections affecting cutaneous structures occur after exposures to infected animals or their products (127, 128). In a period of approximately 4 weeks, the nodule, plaque, or edematous area evolves into an ulcer with undermined borders. He has a Scopus H index of 17. Tuberculosis is a mycobacterial infection that most frequently occurs due to infection with Mycobacterium tuberculosis, an acid-fast bacillus. Dermatol Clin. Clinical spectrum of leprosy and leprosy reactions (reversal reactions and erythema nodosum leprosum). M. chelonae and M. abscessus usually present with multiple skin lesions, while M. fortuitum tends to present as a single lesion (24, 42, 43, 117). ASM journals are the most prominent publications in the field, delivering up-to-date and authoritative coverage of both basic and clinical microbiology. However, NTM are becoming important emerging pathogens in different geographical areas. (21, 22). Curr Opin Infect Dis. Modes of acquisition of MAC infection include trauma, cosmetic procedures (such as pedicures, footbaths, and leg waxing), and postsurgical infections (126). 2020 Aug 6;9(8):641. doi: 10.3390/pathogens9080641. WHO identifies approximately 3,000 to 5,000 cases annually, affecting predominantly children less than 15 years of age (20, 31, 32, 109). We report here 5 patients with cutaneous and/or soft tissue infection … When M. bovis infection manifests as scrofuloderma, it is often the result of consumption of unpasteurized milk (47, 69, 71). Mycobacterial Species as Human PathogensThe genus Mycobacterium is part of the order Actinomycetales and the phylum Actinobacteria and belongs to a variety of environmental habitats, including natural waters, soils, and drinking water distribution systems (1, 20–23). This progressive clinical form originates through lymphatic spread or by contiguous spread from a lymph node or bone (47). He completed his residency in internal medicine and fellowship in infectious diseases at Emory University in Atlanta, GA. The identification of Buruli ulcer often relies on the presence of characteristic nodules or ulcers, ecological risk factors, and at-risk age groups residing in settings of endemicity. Susceptibility testing for M. leprae involves assessments of specific genetic markers of antimycobacterial resistance (99). See this image and copyright information in PMC. Geography-based environmental exposures influence the epidemiology of cutaneous mycobacterial infections. The WHO recommended the institution of multidrug therapy with dapsone, rifampin, and clofazimine in 1982 (47, 97, 99). This rare type of cutaneous TB occurs on the nasal, oral, or anogenital skin or mucosa and is clinically important to consider in individuals with periorificial nonhealing ulcers. In January 2012, public health officials in New York received reports of Mycobacterium chelonae skin infections … Along with Mycobacterium fortuitum and Mycobacterium chelonae, members of the M. abscessus complex (M. abscessus, Mycobacterium massiliense, and Mycobacterium bolletii) are the major NTM associated with cutaneous involvement (Fig. Most of these presentations occur in the extremities, particularly over joints. Among patients with advanced immunosuppression, Mycobacterium kansasii, the Mycobacterium avium-intracellulare complex, and Mycobacterium haemophilum may cause cutaneous or disseminated disease. Molecular detection methods and phenolic glycolipid 1 (PGL-1) serological data in combination with spatial epidemiology increase detection of leprosy cases (98). Previous sensitization to Mycobacterium tuberculosis, and ecological studies have demonstrated that prevalence! Organ infections spam submissions infections affecting humans ( 19, 21, 22 42. 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