Mycobacterium haemophilum infection with prominent facial manifestation mimicking leprosy.
|
| Abstract |
Mycobacterium haemophilum is a slow-growing non-tuberculous mycobacterium that is rarely known to cause human skin infection, particularly in immunocompromised patients. We recently experienced a 69-year-old Japanese woman with this infection who had been under immunosuppressive treatment for recalcitrant rheumatoid arthritis. The patient showed disseminated erythematous plaques and subcutaneous nodules on the face and extremities, and interestingly, the face manifested with a striking "facies leontina" appearance. Biopsy revealed abscess and granulomatous dermatitis with the involvement of peripheral nerve bundles and the presence of innumerable acid-fast bacilli, thus necessitating differentiation from lepromatous leprosy. M. haemophilum was identified by molecular characterization as well as by successful culture with iron supplements. Although drug susceptibility testing indicated responsiveness to multiple antibiotics administrated simultaneously for the treatment, it took over 6 months to achieve significant improvement, and we also employed concurrent oral potassium iodide administration and repeated surgical excision. This case highlights the importance of continuous combination therapy for successful outcome in this rare infection. Furthermore, application of potassium iodide for mycobacterial infection warrants further evaluation by accumulating more cases.
|
|---|---|
| Authors | Kentaro Ishii, Norihisa Ishii, Kazue Nakanaga, Kazuaki Nakano, Ikuo Saito, Akihiko Asahina |
| Journal | The Journal of dermatology (J Dermatol) Vol. 42 Issue 10 Pg. 992-5 (Oct 2015) ISSN: 1346-8138 [Electronic] England |
| PMID | 26017241 (Publication Type: Case Reports, Journal Article) |
| Copyright | © 2015 Japanese Dermatological Association. |
| Topics |
|
Join CureHunter, for free Research Interface BASIC access!
Realize the full power of the drug-disease research graph!