1/18. Bacterial interdigital scaly erythema (Kitamura): a possible new clinical entity.Four patients with scaly erythema on their finger webs and sides of their fingers during summer are described. These patients were working in either butcher's shops or a sushi bar, where they handled raw meat, chicken or fish for many hours. The eruptions first appeared as scaly erythema, sometimes accompanied by small pustules, on the second, third and fourth finger webs, and later the erythema extended to the sides of the fingers and palms. Maceration and/or shallow erosion sometimes appeared on the finger webs. Symptoms were usually mild; the patients complained of slight itching, irritation or pain. Direct examination of specimens stained with Parker blue-black ink containing KOH revealed scales containing bacterial granules or filaments. Several species of bacteria were cultured including corynebacterium sp. Fungus was not detected in either KOH specimens or in cultures. The lesions responded rapidly to topical or oral antibiotics; however, they recurred frequently during hot and humid weather. Hitherto a similar condition has not been described and is possibly a new clinical entity. copyright (R) 2000 S.Karger AG, Basel- - - - - - - - - - ranking = 1keywords = bacterium (Clic here for more details about this article) |
2/18. mycobacterium marinum hand infection: case reports and review of literature.Three patients with mycobacterium marinum infection are described. Key elements in the diagnosis of this infection are a high index of suspicion, taking a history with an emphasis on exposure to tropical fish or other potential sources of M. marinum infection, and tissue biopsy for culture and histology. The microbiologist should be informed about the suspicion of M. marinum infection so that appropriate cultures can be performed. As M. marinum does not grow under routine culture conditions, the diagnosis is easily missed resulting in delayed treatment. The treatment is essentially antimicrobial therapy for the superficial lesions supplemented by an appropriate surgical debridement especially when deep structures are involved.- - - - - - - - - - ranking = 5keywords = bacterium (Clic here for more details about this article) |
3/18. Atypical cutaneous mycobacteriosis diagnosed by polymerase chain reaction.Atypical mycobacteria are important human pathogens. Although they often cause systemic disease, mycobacterial infection may present solely as cutaneous lesions. It is not easy to detect nontuberculous mycobacteria by the traditional histochemical Ziehl-Neelsen stain, or by culture on specific media. polymerase chain reaction (PCR) may be used to identify nontuberculous mycobacteria in skin lesions. We report a 40-year-old man and a 36-year-old woman, both of whom were immunocompetent and kept fish, who had skin lesions on the backs of their right hands. Ziehl-Neelsen staining and culture on Lowenstein-Jensen media were negative. Mycobacterial dna was detected by amplification of 16S ribosomal dna. In both cases, PCR-enzyme-linked immunosorbent assay showed a positive signal when probes for Mycobacterium (universal probe) and M. chelonae were used, and in one patient M. fortuitum was also discovered. Antibiotic therapy with clarithromycin 500 mg twice daily was begun. After 6 months of treatment, the skin lesions were cured.- - - - - - - - - - ranking = 1keywords = bacterium (Clic here for more details about this article) |
4/18. mycobacterium marinum infection.A 49-year-old man presented with nodules on his right hand after a history of mycobacterium marinum infection recently treated with rifampin and clarithromycin. The patient has an aquarium with Betta fish (Siamese fighting fish).- - - - - - - - - - ranking = 5keywords = bacterium (Clic here for more details about this article) |
5/18. Aquatic hazard mycobacterium marinum infection.We describe two patients with mycobacterium marinum infection and review the pertinent literature. M. marinum infection follows trauma, often trivial, in water or from marine life. Clinical manifestations include superficial cutaneous lesions which are either solitary or multiple in a sporotrichoid distribution, involvement of the deeper structures of the hand and wrist and disseminated disease. biopsy of infected tissue reveals a mixed suppurative-granulomatous reaction with sparse to absent acid-fast bacilli. Definitive diagnosis is achieved by growing the organism from appropriate specimens. Suggested therapeutic regimens consist of rifampin and ethambutol for advanced disease and infection invading the deeper structures of the hand and wrist and one of the tetracyclines or trimethoprim-sulfamethoxazole for early or minimal disease. Surgical debridement is advised when there is persistent pain, a discharging sinus or previous local injection of corticosteroids.- - - - - - - - - - ranking = 5keywords = bacterium (Clic here for more details about this article) |
6/18. A look-back investigation of patients of an hiv-infected physician. public health implications.BACKGROUND. Transmission of the human immunodeficiency virus (hiv) to five patients receiving care from an hiv-infected dentist in florida has recently been reported. Current data indicate that the risk of hiv transmission from health care workers to patients is low. Despite this low risk, programs to notify patients of past exposure to an hiv-infected health care worker are being conducted with increasing frequency. methods. We recently conducted an investigation of all the patients cared for by an hiv-infected family physician during a period when he had severe dermatitis caused by mycobacterium marinum on his hands and forearms. After reviewing the patients' records, we notified 336 patients who had undergone one or more procedures (digital examination of a body cavity or vaginal delivery) placing them at potentially increased risk of hiv infection. The patients were offered tests for hiv infection and counseling. RESULTS. Of the 336 patients, 325 (97 percent) had negative tests for hiv antibody, 3 (1 percent) refused testing, 1 (less than 1 percent) died of a cause unrelated to hiv infection before notification, and the hiv-antibody status of 7 (2 percent) remained unknown. The direct and indirect public health costs of this investigation were approximately $130,000. CONCLUSIONS. The results of this investigation raise important questions about the risk of hiv transmission from health care workers to patients and the usefulness of hiv look-back programs, particularly in the light of recently published recommendations from the Centers for disease Control. We propose that before a look-back investigation is undertaken, there should be a clearly identifiable risk of transmission of the infection, substantially higher than the risk requiring limitation of an hiv-infected health care worker's practice prospectively.- - - - - - - - - - ranking = 1keywords = bacterium (Clic here for more details about this article) |
7/18. Treatment of mycobacterium chelonae infection with controlled localized heating.An immunocompetent man acquired a localized cutaneous infection caused by the atypical mycobacterium mycobacterium chelonae. This was successfully treated with controlled localized heating with a hand-held radiofrequency heat generator. Possible mechanisms of effects of heat on this organism are discussed.- - - - - - - - - - ranking = 6keywords = bacterium (Clic here for more details about this article) |
8/18. Multiple subcutaneous abscesses due to mycobacterium tuberculosis in an immunocompetent host.A 58-year-old immunocompetent man presented with a 9-month history of several disseminated subcutaneous ulcerative nodules, fever and weight loss. Histopathological changes were not specific. X-ray of the chest disclosed a large right hilar density highly suggestive of a lung carcinoma. All these manifestations eventually proved to be caused by mycobacterium tuberculosis, which grew from sputum and skin. We report this case because of its striking clinical features.- - - - - - - - - - ranking = 5keywords = bacterium (Clic here for more details about this article) |
9/18. Aquarium-borne mycobacterium marinum skin infection. Report of a case and review of the literature.A 33-year-old fish fancier developed a protracted skin infection that ultimately was found to be caused by mycobacterium marinum. The organism was isolated from the lesion as well as from infected fish taken from his home aquarium. The lesion resolved after a six-week course of oral sulfamethoxazole and trimethoprim. Forty-four additional cases of culture-proved M marinum skin infections acquired from aquariums and reported in the English-language literature are reviewed. Almost universally, the lesions remained circumscribed and were either single nodular (14 patients) or multiple sporotrichoid (31 patients). diagnosis was supported by acid-fast smears (15 patients) and isolation of the organism from skin lesions (43 patients) or from fish (two cases). in vitro studies, as well as clinical outcomes, suggest sulfamethoxazole-trimethoprim or ethambutol hydrochloride plus rifampin to be the drugs of choice.- - - - - - - - - - ranking = 5keywords = bacterium (Clic here for more details about this article) |
10/18. Tuberculoid cutaneous infection due to a niacin-positive Mycobacterium chelonei.A case of cutaneous infection due to a niacin-positive Mycobacterium chelonei (previously called M. abscessus) on the dorsum of the hand of a professional cotton-classifier is reported from hong kong. The infection was probably directly acquired from handling contaminated raw cotton. The patient was successfully treated with combined anti-tuberculous drugs over a period of 1 year. Histologically, the skin lesion showed tuberculoid granulomas, in addition to abscesses.- - - - - - - - - - ranking = 5keywords = bacterium (Clic here for more details about this article) |
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