1/6. Familial cluster of cutaneous Mycobacterium avium infection resulting from use of a circulating, constantly heated bath water system.We describe familial cases of cutaneous infection caused by Mycobacterium avium. A 45-year-old father, his 14-year-old son and 11-year-old daughter, among five persons in a family, presented with a 2-month history of inflammatory subcutaneous nodules and ulcerations. histology of skin biopsy specimens showed granulomatous inflammation, and mycobacterial colonies isolated from the skin of each patient were identified as M. avium by dna hybridization analysis. The patients were all treated successfully with combined drug therapy consisting of rifampicin, isoniazid and clarithromycin. Their lesions were purely cutaneous M. avium infection, without any visceral involvement. Neither systemic disease nor immunological impairment was detected in the family. However, they all used a circulating, constantly heated bath water system. The bath water was continuously heated to about 40 degrees C without changing the water for a few months, and M. avium was isolated from the filter of the bath tub heating unit. It is considered that this unusual familial cluster of cutaneous M. avium infection in healthy persons may have resulted from the use of contaminated bath water.- - - - - - - - - - ranking = 1keywords = hybridization (Clic here for more details about this article) |
2/6. A case of systemic osteomyelitides due to Mycobacterium avium.A case of multiple osteomyelitides due to Mycobacterium avium (M. avium) infection with osteosclerotic bone lesions is reported. A 67-year-old male had been suffering from persistent fever and back pain since October 1999, and 20.0-2.5 mg prednisolone per day was prescribed for continuous inflammatory symptoms in January 2000. Six months later, computed tomography revealed osteosclerotic lesions in the left femur and thoracic vertebrae, but no skin lesion associated with mastocytosis or internal malignancy was identified. In September of 2002, a dome-shaped, soft subcutaneous tumor developed on the upper sternum. Histopathological findings revealed subcutaneous adipose tissue with several foci of tiny abscesses. Two weeks later, creamy pus was discharged through a draining sinus at the center of the wound. M. avium was demonstrated in the pus by Zeel-Nielsen staining and microplate hybridization.- - - - - - - - - - ranking = 1keywords = hybridization (Clic here for more details about this article) |
3/6. Primary septicemia caused by vibrio cholerae non-o1 acquired on Cape Cod, massachusetts.We describe a patient with non-O1, non-O139 Vibrio cholerae septicemia associated with hemorrhagic bullous skin lesions of the lower extremities. The patient had underlying liver disease, and he probably acquired the organism through ingestion of raw clams. Although his condition rapidly improved during appropriate therapy, the patient's cellulitis and skin lesions persisted and he developed a fluid collection of the lower extremity that required drainage. Molecular methods were used to examine the non-O1 V. cholerae isolate for several known virulence factors of V. cholerae O1. The isolate failed to express cholera toxin and toxin-coregulated pilus (Tcp) and was negative in Southern hybridizations for ctxB, tcpA, toxR, and toxT. The vast majority of vibrio infections in the United States are clustered in the Gulf Coast area. This patient acquired the infection on Cape Cod. To our knowledge, this is the first case of non-O1 V. cholerae septicemia reported to have occurred in massachusetts. Given the high fatality rate of this infection, it is important for physicians to consider this diagnosis in patients who have underlying risk factors and appropriate epidemiologic exposures, even when they reside as far north as the new england states.- - - - - - - - - - ranking = 1keywords = hybridization (Clic here for more details about this article) |
4/6. Infection with Mycobacterium avium-intracellulare with abscess, ulceration and fistula formation.Infections caused by Mycobacterium avium-intracellulare complex are generally manifested as pulmonary disease, osteomyelitis or lymphadenitis, and cutaneous infection is rare. We describe a case of M. intracellulare infection of the skin in a 79-year-old man without apparent immunologically disabling disease or therapy. He had cutaneous infection of the right hand over 10 years, developing a fistula and, finally, an ulcer and abscess, 2 months before his death from heart failure. Mycobacterium intracellulare was identified by both microbiological characteristics and dna-dna hybridization.- - - - - - - - - - ranking = 1keywords = hybridization (Clic here for more details about this article) |
5/6. A pediatric case of atypical Mycobacterium avium infection of the skin.We report a case of cutaneous atypical mycobacteriosis in a 12-year-old healthy girl due to Mycobacterium avium. The cutaneous symptoms were three well-defined subcutaneous nodules on both buttocks and on the posterior surface of the left thigh. One had a fistulous opening on the skin surface. Histopathological examination revealed epithelioid cell granulomas surrounded by dense lymphocytic infiltration and acid-fast bacteria were seen with modified periodic acid-carbol fuchsin staining. Using Ogawa's medium at 37 degrees C, acid-fast bacteria were isolated from the biopsied specimen and identified by the dna-dna hybridization method as Mycobacterium avium. In drug susceptibility test, these were resistant to all antituberculous drugs. Oral administration of minocycline 100 mg/day for two months had little effect on the two remaining lesions, which were therefore excised. Based upon reported cases of mycobacterium avium complex, we considered that our pediatric patient with multiple intradermal or subcutaneous nodules on the buttocks and the thigh exhibited the characteristic symptoms of M. avium infection.- - - - - - - - - - ranking = 1keywords = hybridization (Clic here for more details about this article) |
6/6. polymerase chain reaction-reverse cross-blot hybridization assay in the diagnosis of sporotrichoid mycobacterium marinum infection.In this paper, we report a patient in whom mycobacterium marinum sporotrichoid infection was diagnosed using polymerase chain reaction (PCR) amplification of the 16S rRNA gene and subsequent analysis of the amplified product in a reverse cross-blot hybridization assay with mycobacterial species-specific probes. This molecular method allowed us rapidly to detect and identify this organism directly in the patient's lesional skin biopsy rather than in cultures in conventional media. The identification provided by PCR-reverse cross-blot hybridization assay was confirmed by examination of the morphological and biochemical features and by high-performance liquid chromatography analysis of mycolic acid from the clinical isolate, suggesting the validity of our molecular approach.- - - - - - - - - - ranking = 6keywords = hybridization (Clic here for more details about this article) |