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Arzeno J, Martin S. Postoperative Mycobacterium chelonae Infection Mimicking A Granulomatous Suture Reaction. Dermatol Surg 2021; 47:840-841. [PMID: 33481434 DOI: 10.1097/dss.0000000000002902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Julia Arzeno
- Division of Dermatology, University of California, Los Angeles, CA
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2
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Gu CH, Zhao C, Hofstaedter C, Tebas P, Glaser L, Baldassano R, Bittinger K, Mattei LM, Bushman FD. Investigating hospital Mycobacterium chelonae infection using whole genome sequencing and hybrid assembly. PLoS One 2020; 15:e0236533. [PMID: 33166284 PMCID: PMC7652343 DOI: 10.1371/journal.pone.0236533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 10/20/2020] [Indexed: 11/21/2022] Open
Abstract
Mycobacterium chelonae is a rapidly growing nontuberculous mycobacterium that is a common cause of nosocomial infections. Here we describe investigation of a possible nosocomial transmission of M. chelonae at the Hospital of the University of Pennsylvania (HUP). M. chelonae strains with similar high-level antibiotic resistance patterns were isolated from two patients who developed post-operative infections at HUP in 2017, suggesting a possible point source infection. The isolates, along with other clinical isolates from other patients, were sequenced using the Illumina and Oxford Nanopore technologies. The resulting short and long reads were hybrid assembled into draft genomes. The genomes were compared by quantifying single nucleotide variants in the core genome and assessed using a control dataset to quantify error rates in comparisons of identical genomes. We show that all M. chelonae isolates tested were highly dissimilar, as indicated by high pairwise SNV values, consistent with environmental acquisition and not a nosocomial point source. Our control dataset determined a threshold for evaluating identity between strains while controlling for sequencing error. Finally, antibiotic resistance genes were predicted for our isolates, and several single nucleotide variants were identified that have the potential to modulated drug resistance.
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Affiliation(s)
- Christopher H. Gu
- Department of Microbiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Chunyu Zhao
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Casey Hofstaedter
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Pablo Tebas
- Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Laurel Glaser
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Robert Baldassano
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Kyle Bittinger
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Lisa M. Mattei
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Frederic D. Bushman
- Department of Microbiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
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3
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Abstract
Mycobacterium chelonae is a rapidly growing non-tuberculous mycobacterium, which causes infections of the human skin and soft tissue. Despite an increasing incidence of such infections, patients are often misdiagnosed. We report here 5 patients with cutaneous and/or soft tissue infection due to M. chelonae who were diagnosed and treated at our centre. Two of the 5 patients were on immunosuppressive treatment. While clinical presentations differed in each patient, all had a long history of skin lesions. In addition to careful history-taking, tissue biopsies were obtained for mycobacterial culture and histopathological examination. Culture-directed antibiotic therapy was initiated, which resulted in a slow, but continuous, healing of the lesions. In summary, M. chelonae infections are still relatively rare, but should be considered in both immunocompromised and immunocompetent patients with prolonged skin lesions resistant to standard antibiotic treatment. For diagnosis, tissue analysis for mycobacterial culture and histopathological examination, and once diagnosed, adequate antibiotic treatment, is needed.
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Affiliation(s)
- Ugur Uslu
- Department of Dermatology, Universitätsklinikum Erlangen, DE-91054 Erlangen, Germany.
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4
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Kim BJ, Kim GN, Kim BR, Jeon CO, Jeong J, Lee SH, Lim JH, Lee SH, Kim CK, Kook YH, Kim BJ. Description of Mycobacterium chelonae subsp. bovis subsp. nov., isolated from cattle (Bos taurus coreanae), emended description of Mycobacterium chelonae and creation of Mycobacterium chelonae subsp. chelonae subsp. nov. Int J Syst Evol Microbiol 2017; 67:3882-3887. [PMID: 28895525 DOI: 10.1099/ijsem.0.002217] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Abstract
Three rapidly growing mycobacterial strains, QIA-37T, QIA-40 and QIA-41, were isolated from the lymph nodes of three separate Korean native cattle, Hanwoo (Bos taurus coreanae). These strains were previously shown to be phylogenetically distinct but closely related to Mycobacterium chelonae ATCC 35752T by taxonomic approaches targeting three genes (16S rRNA, hsp6 and rpoB) and were further characterized using a polyphasic approach in this study. The 16S rRNA gene sequences of all three strains showed 99.7 % sequence similarity with that of the M. chelonae type strain. A multilocus sequence typing analysis targeting 10 housekeeping genes, including hsp65 and rpoB, revealed a phylogenetic cluster of these strains with M. chelonae. DNA-DNA hybridization values of 78.2 % between QIA-37T and M. chelonae indicated that it belongs to M. chelonae but is a novel subspecies distinct from M. chelonae. Phylogenetic analysis based on whole-genome sequences revealed a 95.44±0.06 % average nucleotide identity (ANI) value with M. chelonae, slightly higher than the 95.0 % ANI criterion for determining a novel species. In addition, distinct phenotypic characteristics such as positive growth at 37 °C, at which temperature M. chelonae does not grow, further support the taxonomic status of these strains as representatives of a novel subspecies of M. chelonae. Therefore, we propose an emended description of Mycobacterium chelonae, and descriptions of M. chelonae subsp. chelonae subsp. nov. and M. chelonae subsp. bovis subsp. nov. are presented; strains ATCC 35752T(=CCUG 47445T=CIP 104535T=DSM 43804T=JCM 6388T=NCTC 946T) and QIA-37T (=KCTC 39630T=JCM 30986T) are the type strains of the two novel subspecies.
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Affiliation(s)
- Byoung-Jun Kim
- Department of Biomedical Sciences, Microbiology and Immunology, Cancer Research Institute, Institute of Endemic Diseases, and Liver Research Institute, Seoul National University Medical Research Center (SNUMRC), Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ga-Na Kim
- Department of Biomedical Sciences, Microbiology and Immunology, Cancer Research Institute, Institute of Endemic Diseases, and Liver Research Institute, Seoul National University Medical Research Center (SNUMRC), Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Bo-Ram Kim
- Department of Biomedical Sciences, Microbiology and Immunology, Cancer Research Institute, Institute of Endemic Diseases, and Liver Research Institute, Seoul National University Medical Research Center (SNUMRC), Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Che Ok Jeon
- School of Biological Sciences, Chung-Ang University, Seoul, Republic of Korea
| | - Joseph Jeong
- Department of Laboratory Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Seon Ho Lee
- Department of Laboratory Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Ji-Hun Lim
- Department of Laboratory Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Seung-Heon Lee
- Korean Institute of Tubercuosis, Chungbuk, Republic of Korea
| | - Chang Ki Kim
- Korean Institute of Tubercuosis, Chungbuk, Republic of Korea
| | - Yoon-Hoh Kook
- Department of Biomedical Sciences, Microbiology and Immunology, Cancer Research Institute, Institute of Endemic Diseases, and Liver Research Institute, Seoul National University Medical Research Center (SNUMRC), Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Bum-Joon Kim
- Department of Biomedical Sciences, Microbiology and Immunology, Cancer Research Institute, Institute of Endemic Diseases, and Liver Research Institute, Seoul National University Medical Research Center (SNUMRC), Seoul National University College of Medicine, Seoul, Republic of Korea
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5
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Boulavsky JL, Wright HM, Rodriguez-Waitkus PM, DiNardo AR, Woc-Colburn LE, Dao H. Sporotrichoid pattern of Mycobacterium chelonae-abscessus infection. Cutis 2017; 100:E4-E5. [PMID: 29121135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
| | - Holly M Wright
- Department of Dermatology, Baylor College of Medicine, Houston, Texas, USA
| | | | - Andrew R DiNardo
- Department of Medicine, Section of Infectious Disease, Baylor College of Medicine, Houston, Texas, USA
| | - Laila E Woc-Colburn
- National School of Tropical Medicine and the Department of Medicine, Section of Infectious Disease, Baylor College of Medicine, Houston, Texas, USA
| | - Harry Dao
- Department of Dermatology, Baylor College of Medicine, Houston, Texas, USA
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6
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Hurtado Hurtado JS. Adverse effects of immunosuppressive therapy in rheumatic patients: Non-tuberculous mycobacterial infection. Reumatol Clin 2016; 12:118-119. [PMID: 26091953 DOI: 10.1016/j.reuma.2015.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 03/22/2015] [Accepted: 04/17/2015] [Indexed: 06/04/2023]
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7
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Tsutsumi R, Yamada N, Yoshida Y, Nakanaga K, Ishii N, Yamamoto O. Disseminated Mycobacterium chelonae Infection Identified by Repeated Skin Sampling and Molecular Methods in a Patient with Rheumatoid Arthritis. Acta Derm Venereol 2016; 96:132-3. [PMID: 26122695 DOI: 10.2340/00015555-2188] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
MESH Headings
- Aged
- Anti-Bacterial Agents/therapeutic use
- Arthritis, Rheumatoid/diagnosis
- Arthritis, Rheumatoid/drug therapy
- Arthritis, Rheumatoid/immunology
- Biopsy
- DNA, Bacterial/genetics
- Drug Therapy, Combination
- Female
- Glucocorticoids/adverse effects
- Humans
- Immunocompromised Host
- Molecular Diagnostic Techniques
- Mycobacterium Infections, Nontuberculous/diagnosis
- Mycobacterium Infections, Nontuberculous/drug therapy
- Mycobacterium Infections, Nontuberculous/immunology
- Mycobacterium Infections, Nontuberculous/microbiology
- Mycobacterium chelonae/drug effects
- Mycobacterium chelonae/genetics
- Mycobacterium chelonae/immunology
- Mycobacterium chelonae/isolation & purification
- Opportunistic Infections/diagnosis
- Opportunistic Infections/drug therapy
- Opportunistic Infections/immunology
- Opportunistic Infections/microbiology
- Polymerase Chain Reaction
- Predictive Value of Tests
- Ribotyping
- Skin/drug effects
- Skin/immunology
- Skin/microbiology
- Skin/pathology
- Skin Diseases, Bacterial/diagnosis
- Skin Diseases, Bacterial/drug therapy
- Skin Diseases, Bacterial/immunology
- Skin Diseases, Bacterial/microbiology
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Affiliation(s)
- Reiko Tsutsumi
- Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago-shi,, Tottori 683-8503, Japan.
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8
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Affiliation(s)
- Ashish Bhargava
- Division of Infectious Diseases, St John's Hospital and Medical Center, Detroit, Michigan
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9
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Zhang X, Liu W, Liu W, Jiang H, Zong W, Zhang G, Jin P, Wang H. Cutaneous infections caused by rapidly growing mycobacteria: case reports and review of clinical and laboratory aspects. Acta Derm Venereol 2015; 95:985-9. [PMID: 25809023 DOI: 10.2340/00015555-2105] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Skin and soft tissue infections caused by rapidly growing non-tuberculous mycobacteria (RG-NTM) have become a growing clinical concern over the past decades. These RG-NTM are ubiquitous environmental organisms and most are resistant to traditional antituberculous agents. In this report, we describe 3 cutaneous infections caused by RG-NTM, namely, Mycobacterium abscessus, M. chelonae, and M. conceptionense, and present the clinical and laboratory characteristics of these infections.
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Affiliation(s)
- Xiaodong Zhang
- Department of Dermatology, National Center of Leprosy Control, China CDC; Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College; Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042 Nanjing, China
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10
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Chatzikokkinou P, Luzzati R, Sotiropoulos K, Katsambas A, Trevisan G. Disseminated cutaneous infection with Mycobacterium chelonae in a renal transplant recipient. Cutis 2015; 96:E6-E9. [PMID: 26682566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Mycobacterium chelonae belongs to a rapidly growing group of nontuberculous mycobacteria (NTM). These organisms are environmental saprophytes that can cause infection in humans. Nontuberculous mycobacteria infections have been described in immunosuppressed patients (eg, in the setting of AIDS or immunotherapy following solid organ transplantation) as well as in immunocompetent patients with certain predisposing factors (eg, recent history of a traumatic wound, recent drug injections, impaired cell-mediated immunity). Due to the increasing prevalence of immune deficiency disorders as well as the rising number of cosmetic procedures performed on healthy individuals, NTM may become a frequent cause of serious morbidity, causing chronic infections of the skin, soft tissue, and lungs. We report a case of M chelonae infection in a 61-year-old woman who was receiving immunosuppressive therapy following renal transplantation 6 years prior to presentation. It is important for clinicians to consider NTM in the differential diagnosis for patients who present with chronic skin or soft tissue infections.
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Affiliation(s)
- Paraskevi Chatzikokkinou
- Department of Dermatology and Venereology, University Hospital of Trieste, Ospedale Maggiore, Italy
| | - Roberto Luzzati
- Infectious Diseases Unit, University Hospital of Trieste, Ospedale Maggiore, Italy
| | - Konstantinos Sotiropoulos
- Second Department of Internal Medicine-Propaedeutic, Athens University Medical School, Attikon University Hospital, Greece
| | - Andreas Katsambas
- Department of Dermatology and Venereology, School of Medicine, National and Kapodistrian University of Athens, Andreas Syggros Hospital, Greece
| | - Giusto Trevisan
- Department of Dermatology and Venereology, University Hospital of Trieste, Ospedale Maggiore, Italy
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11
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Edens C, Liebich L, Halpin AL, Moulton-Meissner H, Eitniear S, Zgodzinski E, Vasko L, Grossman D, Perz JF, Mohr MC. Mycobacterium chelonae Eye Infections Associated with Humidifier Use in an Outpatient LASIK Clinic--Ohio, 2015. MMWR Morb Mortal Wkly Rep 2015; 64:1177. [PMID: 26492452 DOI: 10.15585/mmwr.mm6441a4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Laser-assisted in situ keratomileusis (LASIK) eye surgery is increasingly common, with approximately 600,000 procedures performed each year in the United States. LASIK eye surgery is typically performed in an outpatient setting and involves the use of a machine-guided laser to reshape the lens of the eye to correct vision irregularities. Clinic A is an ambulatory surgery center that performs this procedure on 1 day each month. On February 5, 2015, the Toledo-Lucas County Health Department (TLCHD) in Ohio was notified of eye infections in two of the six patients who had undergone LASIK procedures at clinic A on January 9, 2015. The two patients experienced eye pain after the procedures and received diagnoses of infection with Mycobacterium chelonae, an environmental organism found in soil and water.
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12
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Kotzen M, Sell J, Mathes RW, Dentinger C, Lee L, Schiff C, Weiss D. Using Syndromic Surveillance to Investigate Tattoo-Related Skin Infections in New York City. PLoS One 2015; 10:e0130468. [PMID: 26076006 PMCID: PMC4468107 DOI: 10.1371/journal.pone.0130468] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 05/20/2015] [Indexed: 12/03/2022] Open
Abstract
In response to two isolated cases of Mycobacterium chelonae infections in tattoo recipients where tap water was used to dilute ink, the New York City (NYC) Department of Health and Mental Hygiene conducted an investigation using Emergency Department (ED) syndromic surveillance to assess whether an outbreak was occuring. ED visits with chief complaints containing the key word "tattoo" from November 1, 2012 to March 18, 2013 were selected for study. NYC laboratories were also contacted and asked to report skin or soft tissue cultures in tattoo recipients that were positive for non-tuberculosis mycobacterial infection (NTM). Thirty-one TREDV were identified and 14 (45%) were interviewed to determine if a NTM was the cause for the visit. One ED visit met the case definition and was referred to a dermatologist. This individual was negative for NTM. No tattoo-associated NTM cases were reported by NYC laboratories. ED syndromic surveillance was utilized to investigate a non-reportable condition for which no other data source existed. The results were reassuring that an outbreak of NTM in tattoo recipients was not occurring. In response to concerns about potential NTM infections, the department sent a letter to all licensed tattoo artists advising them not to dilute tattoo ink with tap water.
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Affiliation(s)
- Mollie Kotzen
- New York City Department of Health and Mental Hygiene, Queens, New York, United States of America
- New York University, New York, New York, United States of America
| | - Jessica Sell
- New York City Department of Health and Mental Hygiene, Queens, New York, United States of America
| | - Robert W. Mathes
- New York City Department of Health and Mental Hygiene, Queens, New York, United States of America
| | - Catherine Dentinger
- New York City Department of Health and Mental Hygiene, Queens, New York, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Lillian Lee
- New York City Department of Health and Mental Hygiene, Queens, New York, United States of America
| | - Corinne Schiff
- New York City Department of Health and Mental Hygiene, Queens, New York, United States of America
| | - Don Weiss
- New York City Department of Health and Mental Hygiene, Queens, New York, United States of America
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13
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Mankad S, Karthik R, Rupali P, Michael JS. Fatal Disseminated Mycobacterium chelonae Infection in an Immunocompromised Host--A Unique Presentation. J Assoc Physicians India 2015; 63:49-52. [PMID: 26591128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Disseminated disease due to rapidly growing non tuberculous mycobacteria especially in the immunocompromised host is being increasingly reported. The usual manifestations of disease being skin and soft tissue infection, post operative wound infection and pulmonary disease. We present a case of a disseminated infection due to Mycobacterium chelonae with features of chronic meningitis and knee joint arthritis in a patient with systemic lupus erythematosus on systemic steroids and mycophenolate. M chelonae was isolated from both synovial and cerebrospinal fluid and anti microbial therapy was initiated as per sensitivity results. However the patient's clinical condition continued to worsen and she succumbed to her illness.
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14
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Maverakis E, He Y, Patel FB, Fitzmaurice S, Fung MA. Mycobacterium chelonae infection presenting as recurrent cutaneous and subcutaneous nodules--a presentation previously diagnosed as Weber Christian disease. Dermatol Online J 2014; 20:13030/qt9k9535t1. [PMID: 24945648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 06/13/2014] [Indexed: 06/03/2023] Open
Abstract
Although the dermatologic community rarely uses "Weber-Christian Disease" as a diagnosis, it still appears in the internal medicine literature. Herein we present a patient with recurrent cutaneous and subcutaneous nodules who was initially treated with aggressive immunosupression for a presumptive diagnosis of Weber-Christian Disease. After more than a decade the patient was diagnosed with cutaneous Mycobacterium chelonea. This case is an excellent example of the difficulty in diagnosing mycobacterial infections and underscores the importance of having a high suspicion for infectious etiologies for unresponsive cutaneous eruptions in patients on immunosuppressive medications.
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15
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Zhang YY, Li YB, Huang MX, Zhao XQ, Zhang LS, Liu WE, Wan KL. Novel species including Mycobacterium fukienense sp. is found from tuberculosis patients in Fujian Province, China, using phylogenetic analysis of Mycobacterium chelonae/abscessus complex. Biomed Environ Sci 2013; 26:894-901. [PMID: 24331534 DOI: 10.3967/bes2013.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 03/30/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To identify the novel species 'Mycobacterium fukienense' sp. nov of Mycobacterium chelonae/abscessus complex from tuberculosis patients in Fujian Province, China. METHODS Five of 27 clinical Mycobacterium isolates (Cls) were previously identified as M. chelonae/abscessus complex by sequencing the hsp65, rpoB, 16S-23S rRNA internal transcribed spacer region (its), recA and sodA house-keeping genes commonly used to describe the molecular characteristics of Mycobacterium. Clinical Mycobacterium isolates were classified according to the gene sequence using a clustering analysis program. Sequence similarity within clusters and diversity between clusters were analyzed. RESULTS The 5 isolates were identified with distinct sequences exhibiting 99.8% homology in the hsp65 gene. However, a complete lack of homology was observed among the sequences of the rpoB, 16S-23S rRNA internal transcribed spacer region (its), sodA, and recA genes as compared with the M. abscessus. Furthermore, no match for rpoB, sodA, and recA genes was identified among the published sequences. CONCLUSION The novel species, Mycobacterium fukienense, is identified from tuberculosis patients in Fujian Province, China, which does not belong to any existing subspecies of M. chelonea/abscessus complex.
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Affiliation(s)
- Yuan Yuan Zhang
- State Key Laboratory for Infections Disease Prevention and Control/National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
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16
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Gui J, Wang F, Hong CY, Li JL, Liang J. [Drug sensitivity analysis of Mycobacterium chelonae and Mycobacterium abscessus and evaluation of Etest for susceptibility testing]. Zhonghua Jie He He Hu Xi Za Zhi 2013; 36:567-571. [PMID: 24252731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To study the drug resistance profile of Mycobacterium(M.) chelonae and M.abscessus and to evaluate the clinical application of Etest(epsilometer test) for susceptibility testing. METHODS Twenty clinical isolates of M.abscessus and 16 clinical isolates of M.chelonae from clinical specimens were collected.Strain identification was carried out by GenoType Mycobacterium CM assay(Hain Lifescience, Germany). The accuracy was evaluated by comparing Etest results to those obtained by broth microdilution. Thirty-six isolates were tested against amikacin, cefoxitin, ciprofloxacin, clarithromycin, doxycycline, imipenem, linezolid, sulfamethoxazole and tobramycin. The agreement among MICs and interpretive category was evaluated. Chi-squared test was used to compare observed frequency of each of the 2 examples. RESULTS All of the isolates(36/36) were sensitive to amikacin and cefoxitin, and only 1 isolate(1/36) was resistant to clarithromycin, but more isolates(29/36) were resistant to ciprofloxacin, doxycycline, imipenem and sulfamethoxazole.For M.chelonae, only 2/16 were resistant to linezolid, and 7/16 resistant to tobramycin.For M.abscessus, more than 12/20 were resistant to linezolid and 16/20 resistant to tobramycin. The agreement between broth microdilution MICs and Etest MICs for 9 drugs was 149/324.With amikacin, clarithromycin, doxycycline and imipenem, the agreement for interpretive category was excellent(35/36), followed by sulfamethoxazole(34/36), which corresponded to rarely very major error of 2/36.With ciprofloxacin and tobramycin, agreement for interpretive category was 31/36 and 26/36.With cefoxitin and linezolid, the agreement of Etest MICs was the lowest(14/36), resulting in the resistant category. CONCLUSIONS Isolates of M.chelonae and M.abscessus exhibit far more susceptibility to amikacin, cefoxitin and clarithromycin than any other antimicrobial agents.Linezolid and tobramycin showed sensitivity to some isolates of M.chelonae.It is suitable for the Etest method as a simple reliable method for the drug susceptibility of amikacin, ciprofloxacin, clarithromycin, doxycycline, imipenem, and tobramycin except to cefoxitin and linezolid. The Etest method of determining sulfamethoxazole susceptibility should be careful.
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Affiliation(s)
- Jing Gui
- Department of Pathogenic Laboratory, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China
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Dolz-Marco R, Udaondo P, Gallego-Pinazo R, Millán JM, Díaz-Llopis M. Topical linezolid for refractory bilateral Mycobacterium chelonae post-laser-assisted in situ keratomileusis keratitis. ACTA ACUST UNITED AC 2013; 130:1475-6. [PMID: 23143454 DOI: 10.1001/archophthalmol.2012.1495] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
MESH Headings
- Acetamides/administration & dosage
- Adult
- Anti-Infective Agents/administration & dosage
- Cornea/microbiology
- Cornea/pathology
- Cornea/surgery
- Drug Resistance, Bacterial
- Eye Infections, Bacterial/drug therapy
- Eye Infections, Bacterial/etiology
- Eye Infections, Bacterial/microbiology
- Follow-Up Studies
- Humans
- Keratitis/drug therapy
- Keratitis/etiology
- Keratitis/microbiology
- Keratomileusis, Laser In Situ/adverse effects
- Linezolid
- Male
- Mycobacterium Infections, Nontuberculous/drug therapy
- Mycobacterium Infections, Nontuberculous/etiology
- Mycobacterium Infections, Nontuberculous/microbiology
- Mycobacterium chelonae/isolation & purification
- Myopia/surgery
- Oxazolidinones/administration & dosage
- RNA, Ribosomal, 23S
- Surgical Wound Infection/drug therapy
- Surgical Wound Infection/etiology
- Surgical Wound Infection/microbiology
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18
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Rodriguez JM, Xie YL, Winthrop KL, Schafer S, Sehdev P, Solomon J, Jensen B, Toney NC, Lewis PF. Mycobacterium chelonae facial infections following injection of dermal filler. Aesthet Surg J 2013; 33:265-9. [PMID: 23335647 DOI: 10.1177/1090820x12471944] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED A cluster of 3 facial Mycobacterium chelonae infections occurred after cosmetic dermal filler injections at a plastic surgery clinic. Pulsed-field gel electrophoresis showed that M chelonae isolated from the clinic tap water were identical to the patient wound isolates. Review of injection procedures identified application of nonsterile ice to the skin prior to injection as a possible source of M chelonae. Surveys of regional laboratories and a national plastic surgery listserv identified no other cases related to the injection of this brand of dermal filler. This is the first report of cutaneous M chelonae infections following the injection of dermal fillers. It adds to a growing body of literature on postinjection M chelonae infections and reinforces the importance of optimal skin disinfection steps prior to percutaneous procedures. LEVEL OF EVIDENCE 5.
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Affiliation(s)
- Jan M Rodriguez
- Clackamas County Community Health, 2051 SE Kaen Rd, Oregon City, OR 97045, USA
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19
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Uzoigwe OF. Contaminated ink might be responsible for Mycobacterium chelonae infection after tattooing. BMJ 2013; 346:f122. [PMID: 23364052 DOI: 10.1136/bmj.f122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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20
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Mele AA, Bilancio G, Luciani R, Bellizzi V, Palladino G. [Atypical mycobacterial infection after kidney transplant: two clinical cases]. G Ital Nefrol 2013; 30:gin/00067.5. [PMID: 23832441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Infections are an important cause of morbidity and mortality during kidney transplant. In areas where tuberculosis is not endemic, Mycobacteria other than tuberculosis (MOOT), also known as 'atypical' Mycobacteria, are more frequently involved in mycobacterial infections than M. tuberculosis. The incidence of MOOT infection in renal transplant recipients ranges from 0.16 to 0.38 percent. This low rate of reported incidence is, however, often due to delay in diagnosis and lack of therapeutic protocols. Further difficulty is caused by the interaction of antimycobacterial drugs with the post-transplant immunosuppressive regimen, necessitating close monitoring of plasma concentrations and careful dose modification. We present two cases of Mycobacterium Chelonae infection in kidney transplant recipients which differ in both clinical presentation and pharmacological approach.
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21
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22
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Affiliation(s)
- Y-H Lin
- Departments of Otolaryngology, Head and Neck Surgery, National Taiwan University Hospital, Taipei, Taiwan
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23
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Kennedy BS, Bedard B, Younge M, Tuttle D, Ammerman E, Ricci J, Doniger AS, Escuyer VE, Mitchell K, Noble-Wang JA, O'Connell HA, Lanier WA, Katz LM, Betts RF, Mercurio MG, Scott GA, Lewis MA, Goldgeier MH. Outbreak of Mycobacterium chelonae infection associated with tattoo ink. N Engl J Med 2012; 367:1020-4. [PMID: 22913660 PMCID: PMC10973765 DOI: 10.1056/nejmoa1205114] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
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 in Rochester, New York. The main goals were to identify the extent, cause, and form of transmission of the outbreak and to prevent further cases of infection. METHODS We analyzed data from structured interviews with the patients, histopathological testing of skin-biopsy specimens, acid-fast bacilli smears, and microbial cultures and antimicrobial susceptibility testing. We also performed DNA sequencing, pulsed-field gel electrophoresis (PFGE), cultures of the ink and ingredients used in the preparation and packaging of the ink, assessment of source water and faucets at tattoo parlors, and investigation of the ink manufacturer. RESULTS Between October and December 2011, a persistent, raised, erythematous rash in the tattoo area developed in 19 persons (13 men and 6 women) within 3 weeks after they received a tattoo from a single artist who used premixed gray ink; the highest occurrence of tattooing and rash onset was in November (accounting for 15 and 12 patients, respectively). The average age of the patients was 35 years (range, 18 to 48). Skin-biopsy specimens, obtained from 17 patients, showed abnormalities in all 17, with M. chelonae isolated from 14 and confirmed by means of DNA sequencing. PFGE analysis showed indistinguishable patterns in 11 clinical isolates and one of three unopened bottles of premixed ink. Eighteen of the 19 patients were treated with appropriate antibiotics, and their condition improved. CONCLUSIONS The premixed ink was the common source of infection in this outbreak. These findings led to a recall by the manufacturer.
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Affiliation(s)
- Byron S Kennedy
- Monroe County Department of Public Health, Rochester, New York 14620, USA.
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24
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Centers for Disease Control and Prevention (CDC). Tattoo-associated nontuberculous mycobacterial skin infections--multiple states, 2011-2012. MMWR Morb Mortal Wkly Rep 2012; 61:653-6. [PMID: 22914227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Permanent tattoos have become increasingly common, with 21% of adults in the United States reporting having at least one tattoo. On rare occasions, outbreaks of nontuberculous mycobacterial (NTM) skin infections have been reported after tattooing. In January 2012, public health officials in New York received reports of Mycobacterium chelonae skin infections in 14 New York residents who received tattoos during September-December 2011. All infections were associated with use of the same nationally distributed, prediluted gray ink manufactured by company A. CDC disseminated an Epi-X public health alert to identify additional tattoo-associated NTM skin infections; previously identified cases were reported from three states (Washington, Iowa, and Colorado). Public health investigations by CDC, state and local health departments, and the Food and Drug Administration (FDA) found NTM contamination in tattoo inks used in two of five identified clusters. All infected persons were exposed to one of four different brands of ink. NTM contamination of inks can occur during the manufacturing process as a result of using contaminated ingredients or poor manufacturing practices, or when inks are diluted with nonsterile water by tattoo artists. No specific FDA regulatory requirement explicitly provides that tattoo inks must be sterile. However, CDC recommends that ink manufacturers ensure ink is sterile and that tattoo artists avoid contamination of ink through dilution with nonsterile water. Consumers also should be aware of the health risks associated with getting an intradermal tattoo.
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25
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Anderson ET, Frasca S, Asakawa MG, Fatzinger MH, Johnson J, Marchetere K, Goodale L, Risatti GR, Harms CA. Splenic mycobacteriosis in an Atlantic guitarfish, Rhinobatos lentiginosus Garman. J Fish Dis 2012; 35:541-544. [PMID: 22571467 DOI: 10.1111/j.1365-2761.2012.01367.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- E T Anderson
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
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26
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Binić I, Janković A, Ljubenović M, Gligorijević J, Jančić S, Janković D. Mycobacterium chelonae infection due to black tattoo ink dilution. Am J Clin Dermatol 2011; 12:404-6. [PMID: 21797287 DOI: 10.2165/11589500-000000000-00000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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27
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Lee MR, Keng LT, Shu CC, Lee SW, Lee CH, Wang JY, Lee LN, Yu CJ, Yang PC. Risk factors for Mycobacterium chelonae-abscessus pulmonary disease persistence and deterioration. J Infect 2011; 64:228-30. [PMID: 22101165 DOI: 10.1016/j.jinf.2011.11.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Accepted: 11/07/2011] [Indexed: 11/29/2022]
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30
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Abstract
Reduction mammaplasty is one of the most common plastic surgery procedures performed in the US, with the goal of correcting symptomatic macromastia. More than 70,000 cases were performed in 2009, with few complications and low infection rates. The authors present two cases of breast infections with Mycobacterium fortuitum and one with Mycobacterium chelonei following bilateral reduction mammaplasty. Infection with these organisms is exceptionally rare following breast surgery in the absence of a prosthetic implant. All of the patients had a delayed presentation following complete wound healing and were refractory to first-line antibiotic therapy. All three required long-term antibiotics in consultation with an infectious disease specialist. The patients all required surgical drainage, and two patients also required formal operative debridement. All three patients eventually went on to complete wound healing.
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Affiliation(s)
- Adam K Boettcher
- Grand Rapids Medical Education Partners/Michigan State University Plastic and Reconstructive Surgery Program, Grand Rapids, Michigan, USA.
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31
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Correa NE, Cataño JC, Mejía GI, Realpe T, Orozco B, Estrada S, Vélez A, Vélez L, Barón P, Guzmán A, Robledo J. Outbreak of mesotherapy-associated cutaneous infections caused by Mycobacterium chelonae in Colombia. Jpn J Infect Dis 2010; 63:143-145. [PMID: 20332582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Nidia E Correa
- Corporación para Investigaciones Biológicas, Medellin, Colombia
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32
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Somily AM, Al-Anazi AR, Babay HA, Al-Aska AI, Al-Hedaithy MA, Al-Hamoudi WK, Al Boukai AA, Sabri MS, AlThawadi SI, Kambal AM. Mycobacterium chelonae complex bacteremia from a post-renal transplant patient: case report and literature review. Jpn J Infect Dis 2010; 63:61-64. [PMID: 20093766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
In this report we present a case of a young lady with abdominal abscesses and septicemia caused by Mycobacterium chelonae complex. Identification of the organism and initiation of the appropriate antimicrobial therapy was delayed, resulting in significant morbidity and multiple hospital admissions. Gram staining of these organisms from blood culture can be easily overlooked or confused with either debris or diptheroids. We concluded that detection of Gram-positive rod colonies should prompt an acid-fast stain to distinguish diphtheroids from rapidly growing mycobacteria in immunosuppressed patients.
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Affiliation(s)
- Ali Mohammed Somily
- Department of Pathology, Microbiology Unit, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
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33
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34
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Chung WK, Kim MS, Kim CH, Lee MW, Choi JH, Moon KC, Koh JK. Cutaneous Mycobacterium chelonae infection presenting as symmetrical plaques on both shins in an immunocompetent patient. Acta Derm Venereol 2009; 89:663-4. [PMID: 19997711 DOI: 10.2340/00015555-0693] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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35
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Oz O, Lee DH, Smetana SM, Akduman L. A case of infected scleral buckle with Mycobacterium chelonae associated with chronic intraocular inflammation. Ocul Immunol Inflamm 2009; 12:65-7. [PMID: 15209466 DOI: 10.1076/ocii.12.1.65.28069] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To describe a unique case of chronic intraocular inflammation secondary to scleral buckle infection with Mycobacterium chelonae that was successfully treated with buckle explantation. METHODS Case report. RESULTS A 59-year-old male with a history of retinal detachment repair at the age of 41 presented with chronic, recurrent intraocular inflammation responsive to topical corticosteroids. Conjunctival erosion with exposure of the scleral buckle occurred five months after initial presentation. The scleral buckle was removed and cultured. After three weeks of postoperative topical tobramycin and dexamethasone treatment, the patient has remained symptom-free without medications. The explanted material grew acid-fast bacilli later identified as M. chelonae. CONCLUSIONS This case describes a new finding of chronic intraocular inflammation associated with a scleral buckle infected with M. chelonae and the successful resolution of extraocular infection and intraocular inflammation after buckle removal.
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Affiliation(s)
- Ozay Oz
- Saint Louis University Eye Institute, St. Louis, MO 63104, USA
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36
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Abstract
Following uncomplicated cataract surgery, a patient receiving etanercept for psoriatic arthritis developed Mycobacterium chelonae endophthalmitis. Vitrectomy, capsulectomy, and intraocular lens removal was followed by intravitreal amikacin, topical gatifloxacin, intravenous imipenem, and oral clarithromycin for six months. The patient achieved a final corrected visual acuity of 20/20. Etanercept has been implicated in the development of numerous, severe granulomatous infections, though not previously with M. chelonae. This represents the first reported case of visual recovery following M. chelonae endophthalmitis.
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Affiliation(s)
- Michael W Stewart
- Department of Ophthalmology, Mayo Clinic College of Medicine, Jacksonville, FL 32224, USA.
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37
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Affiliation(s)
- R Fox
- Maternity Unit, Directorate of Obstetrics, Gynaecology and Paediatrics, Taunton and Somerset Hospital, UK.
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39
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Whipps CM, Matthews JL, Kent ML. Distribution and genetic characterization of Mycobacterium chelonae in laboratory zebrafish Danio rerio. Dis Aquat Organ 2008; 82:45-54. [PMID: 19062752 PMCID: PMC2751615 DOI: 10.3354/dao01967] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
During routine screening of zebrafish at a research facility, histological changes consistent with mycobacteriosis were observed, prompting an investigation to determine the background prevalence and distribution of Mycobacterium species throughout the facility. Infection status was evaluated in 240 zebrafish representing 9 genetic lines, using histology, culture and PCR. Environmental sources were also tested for the presence of mycobacteria. Prevalence in zebrafish by culture and PCR was 10% (24/240), 21 of which were TU line fish. All isolates from fish were identified as M. chelonae by hsp65 DNA sequencing; subsequent DNA fingerprinting delineated 3 strains, designated H1E1 (1/24), H1E2 (22/24), and H1E3 (1/24). From external sources, tank or tubing surface biofilms were positive by culture (13/32) with multiple species and strains isolated including M. neoaurum, M. phocaicum, and identical strains of M. chelonae that were found in zebrafish: H1E1 (2/13) and H1E2 (8/13). Comparing diagnostic methods, acid-fast stained histological sections showed substantial agreement with plate culture and PCR for detection of mycobacteria in fish. Observation of granulomas in hematoxylin and eosin-stained sections was a less reliable predictor of mycobacteriosis, as uninfected females with egg-associated inflammation and hyperplasia were misdiagnosed. These data revealed background levels of mycobacteriosis in a healthy and well-managed facility. Infected populations were removed, although the apparent ability for M. chelonae to remain viable in environmental reservoirs may make it difficult to eradicate completely. This highlights the importance of an animal-health monitoring program and good husbandry practices to prevent disease in zebrafish research laboratories.
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Affiliation(s)
- Christopher M Whipps
- State University of New York College of Environmental Science and Forestry, Environmental and Forest Biology, 246 Illick Hall, 1 Forestry Drive, Syracuse, New York 13210, USA.
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40
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Lavania M, Katoch K, Parashar D, Sharma P, Das R, Chauhan DS, Sharma VD, Katoch VM. Predominance of Mycobacterium fortuitum-chelonae complex in Ghatampur field area, endemic for leprosy. Indian J Lepr 2008; 80:323-330. [PMID: 20329381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Non-tuberculous mycobacteria (NTM) are commonly found in the environment. As exposure to environmental mycobacteria has been reported to immunomodulatory in this study, the presence of environmental mycobacteria was investigated in soil, drinking water and drainage sample in Ghatampur, India, which is known for high endemicity for leprosy. Soil, drinking water from the hand pumps/wells and also drainage water collected in pools was collected in clean containers and cultured for environmental mycobacteria. Samples were processed according to the protocol established earlier. 69 soil, 62 drinking water and 31 drainage water samples were analysed from soil and water collected from 48 villages of this field area. After decontamination, cultures were set upon Lowenstein Jensen (LJ) medium. Mycobacteria were identified using biochemical tests and molecular techniques such as PCR-RFLP targeting hsp65 kD and rpoB region as well as 16S ribosomal sequencing in case of isolates showing variable biochemical features. NTM (non-tubercular mycobacteria) were isolated from 47.82% of soil samples, 20.69% of drinking water samples and 19.35% of the drainage water samples, overall mycobacteria could be isolated 52/162 of samples (32.09%). Among these mycobacteria, M. fortuitum-chelonae complex was predominant in this area; other species isolated were M. phlei, M. vaccae, M. terrae and M. flavescens. Relevance of exposure to these mycobacteria on endemicity needs to be studied by immunological and epidemiological parameters.
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MESH Headings
- Bacterial Proteins/chemistry
- Bacterial Proteins/genetics
- Chaperonin 60/chemistry
- Chaperonin 60/genetics
- DNA, Bacterial/chemistry
- DNA, Bacterial/genetics
- Endemic Diseases
- Humans
- India/epidemiology
- Mycobacterium Infections, Nontuberculous/epidemiology
- Mycobacterium Infections, Nontuberculous/microbiology
- Mycobacterium chelonae/genetics
- Mycobacterium chelonae/isolation & purification
- Polymerase Chain Reaction
- Polymorphism, Restriction Fragment Length
- RNA, Ribosomal, 16S/chemistry
- RNA, Ribosomal, 16S/genetics
- Rural Population
- Sequence Analysis, DNA
- Soil Microbiology
- Water Microbiology
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Affiliation(s)
- M Lavania
- Department of Microbiology and Molecular Biology, National JALMA Institute for Leprosy and Other Mycobaceterial Diseases (ICMR), Dr M Miyazaki Marg, Tajganj, Agra - 28200 I, India
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41
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Liang QF, Sun XG, Li Y, Wang ZQ, Luo SY, Li R. Bilateral nontuberculous mycobacterial keratitis after laser in situ keratomileusis. Chin Med J (Engl) 2007; 120:1935-1937. [PMID: 18067772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Affiliation(s)
- Qing-feng Liang
- Department of Ocular Microbiology, Beijing Institute of Ophthalmology, Beijing Tong Ren Hospital, Capital Medical University, Beijing, China
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42
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Hoetzenecker W, Ulmer A, Klingel K, Kempf VAJ, Schanz S, Metzler G, Fierlbeck G. Dissemination of a localized cutaneous infection with Mycobacterium chelonae under immunosuppressive treatment. ACTA ACUST UNITED AC 2007; 143:951-2. [PMID: 17638751 DOI: 10.1001/archderm.143.7.951] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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43
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Abstract
We report a case of postoperative wound infection due to Mycobacterium chelonae. A 35-year-old woman presented with multiple erythematous nodules, plaques and discharging sinuses over the abdomen, 45 days after she had undergone laparoscopic ovarian cystectomy. The seropurulent discharge from the wound showed acid-fast bacilli on Ziehl- Neelsen stain and culture yielded Mycobacterium chelonae. The patient responded to clarithromycin and doxycycline. The source of infection was probably contaminated water or disinfectant solution used for sterilization of laparoscopic instruments.
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Affiliation(s)
- M Rajini
- Department of Microbiology, Sri Devaraj Urs Medical College, Kolar - 563 101, Karnataka, India
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44
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Abstract
While nontuberculous mycobacterial peritonitis is uncommon among peritoneal dialysis (PD) patients, these infections have serious consequences. They present a significant diagnostic and therapeutic challenge for clinicians. Diagnosis can be delayed due to the slow growth rate of some mycobacterial species. These organisms can also be overlooked when adequate culture media are not used in the microbiological evaluation process. The choice of antimicrobial therapy depends upon isolation and speciation of the infecting Mycobacterium species, and prompt catheter removal is essential. Because serious intra-abdominal complications may follow infection, identifying patient risk factors for nontuberculous mycobacterial peritonitis and initiating prompt diagnosis and treatment are essential. We report three cases of peritonitis associated with Mycobacterium chelonae and Mycobacterium gordonae, each with a unique presentation, and discuss the appropriate diagnosis and treatment strategies for the management of PD-associated mycobacterial infections.
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Affiliation(s)
- Mira Rho
- Section of Nephrology, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut 06520-8029, USA
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Therese KL, Deepa P, Therese J, Bagyalakshmi R, Biswas J, Madhavan HN. Association of mycobacteria with Eales' disease. Indian J Med Res 2007; 126:56-62. [PMID: 17890825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND & OBJECTIVES Eales' disease is an idiopathic disease resulting in retinal neovascularization, recurrent haemorrhages, with or without retinal detachment predominantly affecting healthy young males (97.6%) in the Indian subcontinent. Inspite of several studies, the aetiology of Eales' disease is not clear. The isolation of Mycobacterium fortuitum from the aqueous humour of a patient with classical Eales' disease, led us to hypothesize that rapid growing nontuberculous mycobacteria (RGNTM), particularly M. fortuitum and M. chelonae could be associated with Eales' disease. We therefore undertook this study to detect DNA of these RGNTM and also of M. tuberculosis in vitreous fluids (VFs) from patients with Eales' disease and non-Eales' disease. METHODS We developed and optimized seminested polymerase chain reactions (SnPCRs) to detect DNAs of M. fortuitum and M. chelonae on archival ERMs (33) and VFs (19) of Eales' and control patients along with conventional mycobacteriological investigations. RESULTS In the retrospective study, 70 per cent ERM samples were positive for one or more Mycobacterium spp. tested by snPCR. M. fortuitum and M. chelonae were isolated from two VFs, which were also positive by sn PCR in the prospective study. Statistical evaluation of the results of both retrospective and prospective investigations showed a statistically significant association of Mycobacterium spp. with Eales' disease. INTERPRETATION & CONCLUSION The results of the present study suggested the involvement of Mycobacterium spp. in the aetiopathogenesis of Eales' disease. Further studies on a larger sample will be required to confirm these findings.
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Affiliation(s)
- K L Therese
- L & T Microbiology Research Centre, Vision Research Foundation, Chennai 600006, India
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de la Cruz J, Behlau I, Pineda R. Atypical mycobacteria keratitis after laser in situ keratomileusis unresponsive to fourth-generation fluoroquinolone therapy. J Cataract Refract Surg 2007; 33:1318-21. [PMID: 17586393 DOI: 10.1016/j.jcrs.2007.03.035] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2006] [Accepted: 03/08/2007] [Indexed: 11/19/2022]
Abstract
We report a case of post-laser in situ keratomileusis atypical mycobacteria infection unresponsive and resistant to fourth-generation fluoroquinolones, which highlights the importance of a high level of suspicion and the need for multidrug therapy for effective eradication.
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Affiliation(s)
- Jose de la Cruz
- Cornea and Refractive Surgery Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA
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47
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Alexander S, John GT, Jesudason M, Jacob CK. Infections with atypical mycobacteria in renal transplant recipients. INDIAN J PATHOL MICR 2007; 50:482-4. [PMID: 17883113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
Infections due to atypical mycobacteria are infrequent in renal transplant recipients but they cause serious morbidity. These pathogens are common in patients with acquired immune deficiency syndrome (AIDS). We report four proven cases of infections caused with atypical mycobacteriae from 1997 to 2003, by different organisms namely, M. chelonei, M.fortuitum, M. abcessus and M. terrae in renal transplant recipients. Infection with M. terrae documented here is the first occurrence in a renal transplant patient. Histopathological examination of aspirates or biopsy specimens from involved areas and staining and culture for mycobacteriae are essential for diagnosis. Treatment involves antimycobacterial therapy, reduction in immunosuppression and surgery, if indicated. Atypical mycobacterial infections, though currently uncommon, are significant and could prove to be an emerging pathogen in renal transplant recipients in the context of the AIDS epidemic in India.
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Affiliation(s)
- Suceena Alexander
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu
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Jousse-Joulin S, Garre M, Guennoc X, Destombe C, Samjee I, Devauchelle-Pensec V, Saraux A. Skin and joint infection by Mycobacterium chelonae: Rescue treatment with interferon gamma. Joint Bone Spine 2007; 74:385-8. [PMID: 17613267 DOI: 10.1016/j.jbspin.2006.11.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2006] [Accepted: 11/06/2006] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Atypical mycobacteria are environmental organisms that cause opportunistic infections in humans. CASE REPORT A 50-year-old electronics engineer sought advice about starting TNFalpha antagonist therapy for ankylosing spondylitis. Disease duration was 23 years and current treatment was methylprednisolone 4 mg/d. Atypical skin lesions and knee arthritis were noted. Fluid aspirated from the knee showed inflammatory properties and a few acid-fast bacteria, which a line probe assay identified as Mycobacterium chelonae. The same organism was found in a skin biopsy from a thigh lesion. Antimicrobial treatment was started immediately. Inadequate results 6 months later prompted synovectomy of the knee followed by interferon gamma, 50 microg/m(2) body surface area subcutaneously 3 times a week. After 16 months, there were no new skin or joint lesions, and the antimicrobials and interferon gamma were therefore discontinued. CONCLUSION This highly unusual case suggests that interferon gamma may be effective in patients with M. chelonae infection that fails to respond adequately to antimicrobials.
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Tse KC, Lui SL, Cheng VCC, Yip TPS, Lo WK. A cluster of rapidly growing mycobacterial peritoneal dialysis catheter exit-site infections. Am J Kidney Dis 2007; 50:e1-5. [PMID: 17591517 DOI: 10.1053/j.ajkd.2007.04.017] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2007] [Accepted: 04/17/2007] [Indexed: 11/11/2022]
Abstract
In this case series, a cluster of 5 consecutive peritoneal dialysis patients with atypical mycobacterial exit-site infections in a single center within 20 months are described. Clinical features, treatment, and outcomes are discussed. Most patients had been treated with prolonged systemic antibiotic therapy for recurrent bacterial exit-site infections in the preceding months, and all had used topical gentamicin ointment for exit-site infection treatment or prophylaxis. It is postulated that this might have predisposed them to atypical mycobacterial exit-site infection as a result of selection pressure on uncommon organisms.
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Affiliation(s)
- Kai-Chung Tse
- Department of Microbiology, Queen Mary Hospital, Hong Kong
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Sañudo A, Vallejo F, Sierra M, Hoyos JG, Yepes S, Wolff JC, Correa LA, Montealegre C, Navarro P, Bedoya E, Sanclemente G. Nontuberculous mycobacteria infection after mesotherapy: Preliminary report of 15 cases. Int J Dermatol 2007; 46:649-53. [PMID: 17550571 DOI: 10.1111/j.1365-4632.2007.02976.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Mesotherapy is an increasingly used technique which is currently causing several mycobacterial infections owing to contaminated substances being injected, and also to poor aseptic measures being held by nonprofessional practitioners. PATIENTS AND METHODS We collected 15 cases of nontuberculous mycobacteria (NTM) infection after mesotherapy in a 6-month period. RESULTS All patients were female with ages ranging from 19 to 52 years; the main substances injected were procaine and lecithin, and the time between mesotherapy and the appearance of the lesions varied between 1 and 12 weeks. Clinical lesions were mostly nodules and abscesses, which were localized in the abdomen and buttocks in the majority of cases. The main patient complaint was local pain but some presented with systemic symptoms such as fever and malaise. Biopsies reported granulomatous chronic inflammation in the majority of cases. Skin cultures were positive for NTM and Mycobacterium chelonae. DISCUSSION AND CONCLUSIONS Mesotherapy not performed with quality controlled substances can be a predisposing factor for NTM infection.
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Affiliation(s)
- Alejandra Sañudo
- Department of Internal Medicine, Dermatology Section, School of Medicine, San Vicente de Paul Hospital, Medellín, Colombia
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