Cutaneous Mycobacterium chelonae infection distal to the arteriovenous fistula

• Published in: Clinical kidney journal Vol. 9; no. 5; pp. 735 - 738
• Main Authors: Van Ende, Charlotte, Wilmes, Dunja, Lecouvet, Frédéric E, Labriola, Laura, Cuvelier, René, Van Ingelgem, Grégory, Jadoul, Michel
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.10.2016
• Subjects: Vascular Access; haemodialysis; arteriovenous fistula; Mycobacterium chelonae
• ISSN: 2048-8505; 2048-8513
• DOI: 10.1093/ckj/sfw073

A few single cases of Mycobacterium chelonae skin infection have been reported in haemodialysis patients. We report three additional cases that share peculiar clinical characteristics, pointing to diagnostic clues. All three cases presented as erythematous nodules developing distally to a proximal arteriovenous fistula (AVF). This presentation was identical to that of two published cases. A survey of all Belgian haemodialysis units during the period 2007-11 yields an estimated incidence of ∼0.9/10 000 patient-years. Although the source of M. chelonae remains unclear, this specific clinical presentation should be added to the listing of potential complications of an AVF and should be recognized, as it is fully treatable if diagnosed by culture and tissue biopsy.