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Dermatology practice updates in mycobacterial disease
Catherine Barker1, Hesham Alshaikh2,3, Dirk Elston2
1Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA.
International Journal of Dermatology
|December 14, 2023
Summary
Maintain vigilance for cutaneous tuberculosis and atypical mycobacteria, often waterborne. Advanced diagnostics like PCR and MALDI-TOF improve detection and treatment, especially in immunocompromised patients.
Area of Science:
- Infectious Diseases
- Microbiology
- Dermatology
Background:
- Atypical mycobacterial infections are frequently contracted via water exposure.
- Tuberculosis (TB) is endemic globally, with increasing travel and immigration necessitating awareness.
- Public water supplies can harbor mycobacteria, posing risks for surgical site infections due to inadequate sterilization.
Purpose of the Study:
- To emphasize the importance of suspecting cutaneous tuberculosis and atypical mycobacterial infections.
- To highlight advancements in diagnostic techniques for mycobacteria.
- To alert clinicians to the risks in patients on immunosuppressive therapies.
Main Methods:
- Review of common transmission routes and endemicity of mycobacterial infections.
- Discussion of improved diagnostic methods: Auramine-Rhodamine staining, Polymerase Chain Reaction (PCR), and Matrix-Assisted Laser Desorption/Ionization-Time of Flight (MALDI-TOF) mass spectrometry.
- Emphasis on clinical vigilance for at-risk populations.
Main Results:
- Mycobacteria are prevalent in water sources, contributing to infections.
- Newer diagnostic tools offer rapid detection and drug susceptibility testing for mycobacteria.
- Immunosuppressive therapies increase patient susceptibility to these infections.
Conclusions:
- Clinicians must maintain a high index of suspicion for cutaneous tuberculosis and atypical mycobacterial infections.
- Enhanced diagnostic capabilities improve patient outcomes.
- Vigilance is crucial, particularly for patients undergoing immunosuppressive treatment.
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