Keim oder kein Keim: Herausforderungen bei der Diagnose mykobakterieller Infektionen der Haut

[Nontuberculous mycobacteria]

Dermatologically relevant nontuberculous mycobacteria (NTM) include Mycobacterium marinum and Mycobacterium ulcerans and different rapidly growing mycobacteria (RGM). RGM are widely present in the environment and are facultative pathogenic. Diagnostic detection of nontuberculous mycobacteria is frequently challenging. Immune-competent individuals mostly develop localized infections. Immune-suppressed patients may present with severe and disseminated disease. In these cases, rapid initiation of medical treatment is important. Moreover, infections with the more aggressive Mycobacterium ulcerans should be treated early. Due to the risk for the development of inducible antibiotic resistance, antibiotic regimes for NTM infections typically require at least two drugs. Surgical treatment should also be considered. This article discusses clinical presentation, diagnostic workup, and in particular antibiotic treatment options for dermatologically relevant infections caused by NTM.