Characteristics of skin and soft tissue infection caused by non-tuberculous mycobacteria in Taiwan

• Published in: The international journal of tuberculosis and lung disease Vol. 15; no. 6; pp. 811 - 817
• Main Authors: HSIAO, C.-H, TSAI, T.-F, HSUEH, P.-R
• Format: Journal Article
• Language: English
• Published: Paris, France IUATLD 01.06.2011; International Union against Tuberculosis and Lung Disease
• Subjects: Adolescent; Adult; Aged; Antitubercular Agents - therapeutic use; Bacterial diseases; Biological and medical sciences; Child; Clinicopathology; Female; Granulomatous Inflammation; Human bacterial diseases; Humans; Infectious diseases; M. Avium Complex; Male; Medical sciences; Middle Aged; Mycobacterium Infections, Nontuberculous - diagnosis; Mycobacterium Infections, Nontuberculous - drug therapy; Mycobacterium Infections, Nontuberculous - epidemiology; Mycobacterium Marinum; Nontuberculous Mycobacteria - classification; Nontuberculous Mycobacteria - isolation & purification; Ntm; Pneumology; Rapidly Growing Mycobacteria; Respiratory system : syndromes and miscellaneous diseases; Risk Factors; Skin Diseases, Bacterial - diagnosis; Skin Diseases, Bacterial - drug therapy; Skin Diseases, Bacterial - microbiology; Soft Tissue Infections - diagnosis; Soft Tissue Infections - drug therapy; Soft Tissue Infections - microbiology; Taiwan - epidemiology; Treatment Outcome; Tuberculosis and atypical mycobacterial infections; Young Adult; Asia; Taiwan; M. avium complex; Mycobacterium marinum; Respiratory disease; NTM; Inflammation; Mycobacterial infection; Complexes; rapidly growing mycobacteria; Infection; Tuberculosis; Mycobacteriales; Bacteriosis; Mycobacteriaceae; clinicopathology; Bacteria; Actinomycetes; Soft tissue; Skin; granulomatous inflammation; Pneumology
• ISSN: 1027-3719; 1815-7920
• DOI: 10.5588/ijtld.10.0481

SETTING: A medical centre in Taipei, Taiwan.OBJECTIVE: To investigate the clinicopathological and microbiological correlates of skin and soft tissue infection (SSTI) due to non-tuberculous mycobacteria (NTM).DESIGN: Patients with NTM SSTI identified from 1999 to 2009 were included. Histological sections of the skin biopsy specimens from these patients were reassessed.RESULTS: Among 58 patients with NTM SSTI, the most commonly isolated NTM were rapidly growing mycobacteria (RGM; n = 30), Mycobacterium marinum (n = 17) and M. avium complex (MAC) (n = 4). Twenty-nine (50%) of the NTM SSTI involved deep soft tissue; these progressed to local tenosynovitis in 20 patients. All of the cutaneous lesions infected with M. marinum occurred on the upper extremities; in 9 patients the skin eruptions developed after injury in an aquatic environment. Skin lesions with RGM infection usually occurred on the lower extremities, and in 6 patients the infection developed from wounds caused by medical procedures. Granulomatous inflammation with fibrinoid necrosis was present in 47% of lesions in patients with M. marinum infection and suppurative granulomatous inflammation was noted in 45% of patients with RGM infection.CONCLUSIONS: Identification of a close clinicopathological correlate is useful for dermatologists and pathologists in the early diagnosis and treatment of NTM SSTI.