1/20. Cutaneous protothecosis: report of five cases.prototheca, a genus of achlorophyllic algae, is a rare cause of opportunistic infection in humans. About 80 human cases, mostly cutaneous infection caused by P. wickerhamii, have been reported world-wide. We describe the clinicopathological findings and treatments of five cases diagnosed in our department during the period 1991-97. The patients, including four elderly farmers, presented with pyoderma-like lesions or infiltrating papules and plaques on the extensor side of the extremities or face. All patients were immunocompromised, mostly due to systemic or topical steroids. The diagnosis was made in each case by finding typical endospores with morula-like structures in skin biopsy specimens. P. wickerhamii was isolated in four cases in which pretreatment culture of skin tissue was done. Except for one patient who died of asthma, the infection was cured after 2-7 weeks of amphotericin b, ketoconazole, itraconazole or fluconazole. Our cases illustrate that cutaneous protothecosis commonly manifested non-tender, pyoderma-like or infiltrating lesions and should be considered in the differential diagnosis of deep fungal or mycobacterial infection. This rare infection seemed more frequent in our region, possibly due in part to common steroid abuse among old people in taiwan and there was a large population of elderly farmers in our area.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
2/20. Diagnostic odyssey of a cutaneous mycobacteriosis rare in central europe.Cutaneous infection with mycobacterium chelonae is an uncommon disease, although this atypical mycobacterium is an acid-fast bacillus ubiquitous in the environment. It is often misdiagnosed and treated as a fungal or common bacterial infection. We report a case of disseminated atypical mycobacterial skin infection of a 72-year-old woman who was treated with different topical and systemic antimycotic and antibiotic drugs over a period of 5 months without remarkable improvement. Eventually, repeated tissue cultures on special medium and performance of PCR led to the diagnosis of M. chelonae infection. The patient was treated successfully with oral clarithromycin within 8 weeks. In case of abscessing cutaneous infection, M. chelonae should be considered in the differential diagnosis of prolonged disease when common antibiotics are not effective after 2-4 weeks of treatment.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
3/20. rosacea-like lesions due to familial mycobacterium avium-intracellulare infection.Mycobacterium avium-intracellulare (MAI) is a non-tuberculous, nonlepromatous or "atypical" mycobacterium now seen frequently in patients with acquired immunodeficiency syndrome (AIDS). In the past decade, the incidence appears to have increased in non-AIDS patients. Although cutaneous involvement is rare, two brothers without detectable immune defects who both presented with cutaneous MAI infection are described; the older brother also has disseminated disease. The cutaneous presentation of MAI, as well as immune and genetic defects that may predispose to mycobacterial infection, are discussed.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
4/20. Nontuberculous mycobacterial infections of the skin. Report of fourteen cases and review of the literature.This study comprised 14 patients from whose skin nontuberculous mycobacteria were recovered. Most clinical manifestations were relatively nonspecific. Various histopathologic patterns were observed in 22 biopsy specimens. Recurrences were common and prolonged treatment was often necessary. culture of tissue remains the definitive diagnostic procedure. Cutaneous lesions can be the first or only site of nontuberculous mycobacteriosis.- - - - - - - - - - ranking = 4keywords = bacterial infection (Clic here for more details about this article) |
5/20. Sporotrichoid cutaneous infection due to Mycobacterium chelonei in a renal transplant patient.Atypical mycobacterial infections are becoming more common in dermatological practice due to increasing numbers of immunosuppressed patients. A case of cutaneous Mycobacterium chelonei infection with sporotrichoid spread in a renal transplant patient is described, and the current literature regarding clinical spectrum, histopathology and management of infection with this pathogen is reviewed.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
6/20. Sporotrichoid spread of cutaneous Mycobacterium chelonei infection.Atypical mycobacterial infections of the skin have increased in frequency in immunocompromised individuals in recent years. Such patients may follow a different clinical pattern from immunocompetent patients, often lacking a history of preceding trauma and presenting with multiple suppurating subcutaneous nodules. A sporotrichoid pattern of spread may occur with the species mycobacterium kansasii and M. marinum but is rare with M. chelonei.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
7/20. Sporotrichoid pyogenic bacterial infection.Two cases of pyogenic bacterial infection, which initially resembled lymphocutaneous sporotrichosis are reported. In case 1, staphylococcus aureus and streptococcus group A were cultured from the lesion and in case 2, S. aureus alone. Histologically, botryomyotic grains were identified in case 2; this patient had diffuse normolipidemic plane xanthoma. With oral administration of cefaclor, the cutaneous lesions dramatically improved in both cases.- - - - - - - - - - ranking = 5keywords = bacterial infection (Clic here for more details about this article) |
8/20. Scarring following herpes simplex infection of postsurgical cutaneous sites.herpes simplex type 1 produces a perilabial vesicular eruption that normally resolves without scarring. Three cases of herpetic infection associated with different dermatologic surgical procedures are presented. Those procedures involving reduction of cutaneous macrovascular blood supply via undermining or flap creation were followed by clinical scarring. None of the recognized etiologies of tissue compromise (bacterial infection, tension, host vascular disease, excessive inflammation, or edema) could be identified. It is speculated that in the immunocompetent host, small vessel injury secondary to herpes simplex may eventuate in scarring if the subdermal vascular network is significantly compromised. Prophylactic oral acyclovir may be useful in select instances where tissue blood supply is judged clinically tenuous and the frequency of herpetic infection at the surgical site judged worrisome.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
9/20. mycobacterium avium-intracellulare infection associated with hairy-cell leukemia.A 66-year-old man with hairy-cell leukemia was treated successfully with interferon alfa, with normalization of his hematologic parameters. After 2.5 months he became ill again and, following extensive investigation, Mycobacterium avium-intracellulare grew from a bone marrow specimen. Although initiation of quadruple antituberculous chemotherapy resulted in an improvement of his general condition, after two months he started to develop widespread cutaneous and subcutaneous nodules, biopsy of which showed appearances compatible with mycobacterial infection. Over the next two months the skin lesions progressed slowly so erythromycin, to which in vitro testing showed the organism to be sensitive, was added to his therapy. This resulted in a marked improvement of all skin lesions. This case is the first to be reported of disseminated atypical mycobacterial infection in a patient receiving interferon treatment for hairy-cell leukemia.- - - - - - - - - - ranking = 2keywords = bacterial infection (Clic here for more details about this article) |
10/20. skin granulomas due to Mycobacterium gordonae.A 38-year-old woman presented with small, ulcerated, red or bluish nodules on the right hand, clinically resembling mycobacterial granulomas; these appeared a few months after a bite by a rat, while the patient was collecting frogs in a pond in the Belgian Ardennes. The histopathologic picture was compatible with a diagnosis of mycobacterial infection and rare acid-fast bacilli could be found. Repeated bacteriologic investigations were performed and these led to the identification of a strain displaying characteristics of Mycobacterium gordonae. The skin condition responded well to rifampicin (300 mg/day) within 6 months.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
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