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A Delayed Inoculation Model of Chronic Pseudomonas aeruginosa Wound Infection
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A Cold-Blooded Tiptoer: Nonresolving Cellulitis in an Immunocompromised Patient
Satoshi Kitaura1, Koh Okamoto1, Yoshitaka Wakabayashi1
1Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan.
Open Forum Infectious Diseases
|March 21, 2022
Summary
Mycobacterium haemophilum causes skin infections in immunocompromised patients. Genetic sequencing is crucial for accurate diagnosis, as rapid tests may yield false positives.
Area of Science:
- Infectious Diseases
- Microbiology
- Immunology
Background:
- Nontuberculous mycobacteria (NTM) are increasingly recognized pathogens.
- Mycobacterium haemophilum specifically targets skin and soft tissue infections (SSTI).
- Immunocompromised individuals are particularly susceptible to disseminated NTM infections.
Observation:
- A case of disseminated Mycobacterium haemophilum infection presented as persistent cellulitis of the lower extremities.
- The patient's presentation mimicked common bacterial infections, delaying definitive diagnosis.
- Initial diagnostic attempts using a commercial polymerase chain reaction (PCR) test resulted in a false-positive for Mycobacterium intracellulare.
Findings:
- Genetic sequencing confirmed Mycobacterium haemophilum as the causative agent.
- The study underscores the limitations of certain rapid diagnostic tests for NTM identification.
- Accurate identification of Mycobacterium haemophilum is critical for appropriate treatment.
Implications:
- Mycobacterium haemophilum should be considered in the differential diagnosis of SSTI in immunocompromised hosts.
- Clinicians must exercise caution when interpreting results from rapid diagnostic tests for mycobacterial infections.
- Improved diagnostic strategies are needed to ensure timely and effective management of disseminated NTM disease.
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