Cutaneous nontuberculous mycobacteria infections: A retrospective case series of 78 patients from the Texas Gulf Coast region.

Abstract:

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.

journal_name

J Am Acad Dermatol

authors

Philips RC,Hoyer PE,White SM,Tinkey KT,Loeffelholz M,Andersen CR,Wilkerson MG,Gibson BR,Kelly BC

doi

10.1016/j.jaad.2019.04.022

subject

Has Abstract

pub_date

2019-09-01 00:00:00

pages

730-739

issue

3

eissn

0190-9622

issn

1097-6787

pii

S0190-9622(19)30608-5

journal_volume

81

pub_type

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