Journal Information
Vol. 98. Issue 3.
Pages 188-193 (April 2007)
Vol. 98. Issue 3.
Pages 188-193 (April 2007)
Case reports
DOI: 10.1016/S1578-2190(07)70424-9
Full text access
Sporotrichoid Cutaneous Infection by Mycobacterium Haemophilum in an AIDS Patient
Infección Cutánea Esporotricoide por Mycobacterium Haemophilum en un Paciente con Sida
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D. Camesellea,??
Corresponding author
dani.camel@hotmail.com

Correspondence: Servicio de Dermatología. Hospital Universitario Insular de Gran Canaria. Avda. Marítima del Sur, s/n. 35016 Las Palmas de Gran Canaria. Spain.
, J. Hernándeza, A. Francèsb, T. Montenegroc, F. Cañasd, L. Borregoa
a Servicio de Dermatología, Hospital Universitario Insular, Las Palmas de Gran Canaria, Spain
b Unidad de Enfermedades Infecciosas y Medicina Tropical, Hospital Universitario Insular, Las Palmas de Gran Canaria, Spain
c Servicio de Anatomía Patológica, Hospital Universitario Insular, Las Palmas de Gran Canaria, Spain
d Servicio de Microbiología, Hospital Universitario Insular, Las Palmas de Gran Canaria, Spain
Article information
Abstract

We report a case of primary cutaneous infection by Mycobacterium haemophilum after the bite of an aquarium fish in a severely immunodepressed AIDS patient. Clinical features consisted in nodular and ulcerative lesions that followed a sporotrichoid pattern. Histological study of nodular lesions showed a granulomatous dermatitis with numerous acid-fast bacilli. The mycobacterium was identified 3 months later by genetic hybridization from a cultive in solid medium. Combined therapy with isoniazid, rifampin, clarithromycin, ethambutol, amikacin and ciprofloxacin resulted in complete resolution of the lesions. Infection by Mycobacterium haemophilum is a rare mycobacteriosis that usually affects immunodepressed patients. The most common clinical manifestations are cutaneous lesions but the development of sporotrichoid nodular lymphangitis is exceptional.

Key words:
Mycobacterium haemophilum
immunosuppression
sporotrichoid
HIV
AIDS
Resumen

Presentamos un caso de infección primaria cutánea por Mycobacterium haemophilum tras la mordedura de un pez de acuario en un paciente con sida, gravemente inmunodeprimido. Las manifestaciones cutáneas consistieron en lesiones nodulares y ulcerativas que seguían un trayecto esporotricoide. El estudio histológico de las lesiones nodulares mostró una dermatitis granulomatosa con numerosos bacilos ácido-alcohol resistentes. La micobacteria se identificó tres meses después mediante hibridación genética a partir de un cultivo en medio sólido. Se instauró terapia combinada con isoniazida, rifampicina, claritromicina, etambutol, amikacina y ciprofloxacino con curación de las lesiones. La infección por Mycobacterium haemophilum es una micobacteriosis poco frecuente que aparece habitualmente en el paciente inmunodeprimido. Las lesiones cutáneas son las manifestaciones clínicas más frecuentes, pero en forma de linfangitis nodular esporotricoide es excepcional.

Palabras clave:
Mycobacterium haemophilum
inmunodepresión
esporotricoide
VIH
sida
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