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Review
. 2011 Oct;24(4):701-17.
doi: 10.1128/CMR.00020-11.

Clinical manifestations, diagnosis, and treatment of Mycobacterium haemophilum infections

Jerome A Lindeboom  1 , Lesla E S Bruijnesteijn van Coppenraet, Dick van Soolingen, Jan M Prins, Eduard J Kuijper
Affiliations
Review

Clinical manifestations, diagnosis, and treatment of Mycobacterium haemophilum infections

Jerome A Lindeboom et al. Clin Microbiol Rev. 2011 Oct.

Abstract

Mycobacterium haemophilum is a slowly growing acid-fast bacillus (AFB) belonging to the group of nontuberculous mycobacteria (NTM) frequently found in environmental habitats, which can colonize and occasionally infect humans and animals. Several findings suggest that water reservoirs are a likely source of M. haemophilum infections. M. haemophilum causes mainly ulcerating skin infections and arthritis in persons who are severely immunocompromised. Disseminated and pulmonary infections occasionally occur. The second at-risk group is otherwise healthy children, who typically develop cervical and perihilar lymphadenitis. A full diagnostic regimen for the optimal detection of M. haemophilum includes acid-fast staining, culturing at two temperatures with iron-supplemented media, and molecular detection. The most preferable molecular assay is a real-time PCR targeting an M. haemophilum-specific internal transcribed spacer (ITS), but another approach is the application of a generic PCR for a mycobacterium-specific fragment with subsequent sequencing to identify M. haemophilum. No standard treatment guidelines are available, but published literature agrees that immunocompromised patients should be treated with multiple antibiotics, tailored to the disease presentation and underlying degree of immune suppression. The outcome of M. haemophilum cervicofacial lymphadenitis in immunocompetent patients favors surgical intervention rather than antibiotic treatment.

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Figures

Fig. 1.
Fig. 1.
Dendrogram made by using the rpoB gene sequences of 29 mycobacterial species. M. leprae was most closely associated (93.5%).
Fig. 2.
Fig. 2.
Clinical picture of a child with a cervicofacial Mycobacterium haemophilum lymphadenitis presenting as a fluctuant swelling with red skin discoloration.
Fig. 3.
Fig. 3.
Clinical picture of Mycobacterium haemophilum lymphadenitis after skin breakdown.
Fig. 4.
Fig. 4.
Ulcerating open wound as a result of a cervicofacial Mycobacterium haemophilum infection.
See this image and copyright information in PMC

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