Related Experiment Videos
Micrococcus folliculitis in HIV-1 disease
K J Smith1, R Neafie, J Yeager
1Departments of Dermatology and Pathology, National Naval Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889-5600, USA. HSkelIII@aol.com
Abstract:
Organisms with little pathogenic potential in immunocompetent hosts may produce disease in HIV-1 + patients. We describe three HIV-1 + patients in late disease who presented with pruritic papules with central ulceration over the face and arms. In all the patients the eruptions had been present for months, and the patients did not develop sepsis. Biopsy specimens in all the patients showed large Gram-positive cocci, forming tetrads. Colony morphology, catalase positivity and coagulase negativity, and resistance to nitrofurantoin were used to separate micrococci from staphylococci. Micrococcus species are usually considered normal inhabitants of the skin; however, in patients with HIV-1 disease, Micrococcus species can produce localized cutaneous infections.
Insights
Infections caused by Micrococcus species, typically harmless, can occur in individuals with human immunodeficiency virus type 1 (HIV-1) infection. These localized skin infections present as itchy, ulcerated lesions in advanced HIV-1 disease.
Area of Science:
- Microbiology
- Infectious Diseases
- Dermatology
Background:
- Immunocompromised individuals, particularly those with human immunodeficiency virus type 1 (HIV-1), are susceptible to opportunistic infections.
- Cutaneous manifestations are common in advanced HIV-1 disease, often caused by unusual pathogens.
Observation:
- Three patients with advanced HIV-1 disease presented with chronic, pruritic papules and central ulcerations on the face and arms.
- The lesions persisted for months without progressing to sepsis.
Findings:
- Biopsies revealed large Gram-positive cocci in tetrads, identified as Micrococcus species.
- Micrococcus, typically a skin commensal, was differentiated from Staphylococcus using colony morphology, catalase, coagulase tests, and nitrofurantoin resistance.
Implications:
- Micrococcus species should be considered as potential causative agents of localized cutaneous infections in HIV-1 patients.
- This highlights the importance of identifying even typically non-pathogenic organisms in immunocompromised hosts.
- Further research into the pathogenesis of Micrococcus skin infections in HIV-1 is warranted.