Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013:2013:793127.
doi: 10.1155/2013/793127. Epub 2013 Nov 28.

Mycobacterium haemophilum Masquerading as Leprosy in a Renal Transplant Patient

Nathanial K Copeland  1 , Navin S Arora  2 , Tomas M Ferguson  3
Affiliations

Mycobacterium haemophilum Masquerading as Leprosy in a Renal Transplant Patient

Nathanial K Copeland et al. Case Rep Dermatol Med. 2013.

Abstract

Opportunistic infections following immunosuppression in solid organ transplant (SOT) patients are common complications with the skin being a common sight of infection. Nontuberculous mycobacteria (NTM) are rare but potential causes of skin infection in SOT patients. We present a case of an adult male immunosuppressed following renal transplantation who presented with an asymptomatic rash for several months. The patient's skin eruption consisted of erythematous papules and plaques coalescing into an annular formation. After failure of the initial empiric therapy, a punch biopsy was performed that demonstrated nerve involvement suspicious for Mycobacterium leprae. However, culture of the biopsy specimen grew acid-fast bacilli that were subsequently identified as M. haemophilum. His rash improved after a prolonged course of clarithromycin and ciprofloxacin. Both organisms are potential causes of opportunistic skin infections and can be difficult to distinguish with similar predilection for skin and other biochemical and genetic similarities. Ultimately they can be distinguished with culture as M. haemophilum will grow in culture and M. leprae will not. This case was unique due to nerve involvement on biopsy which is classically seen on biopsies of leprosy.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Asymptomatic rash as it appeared following treatment with steroid and antifungal creams characterized by multiple erythematous papules and plaques, some coalescing into an annular pattern.
Figure 2
Figure 2
H&E stain demonstrates dermal nonnecrotizing tuberculoid granulomas interspersed with lymphocytes and rare neutrophils.
Figure 3
Figure 3
Fite stain revealed areas of peripheral nerve involvement in the granulomatous inflammatory process (arrow).
See this image and copyright information in PMC

References

    1. Piersimoni C. Nontuberculous mycobacteria infection in solid organ transplant recipients. European Journal of Clinical Microbiology and Infectious Diseases. 2012;31(4):397–403. - PubMed
    1. Lindeboom JA, van Coppenraet LESB, van Soolingen D, Prins JM, Kuijper EJ. Clinical manifestations, diagnosis, and treatment of Mycobacterium haemophilum infections. Clinical Microbiology Reviews. 2011;24(4):701–717. - PMC - PubMed
    1. Geisler WM, Harrington RD, Wallis CK, Harnisch JP, Conrad Liles W. Broad spectrum of dermatologic manifestations caused by Mycobacterium haemophilum infection. Archives of Dermatology. 2002;138(2):229–230. - PubMed
    1. Busam KJ, Kiehn TE, Salob SP, Myskowski PL. Histologic reactions to cutaneous infections by Mycobacterium haemophilum . American Journal of Surgical Pathology. 1999;23(11):1379–1385. - PubMed
    1. Trindade MAB, Palermo ML, Pagliari C, et al. Leprosy in transplant recipients: report of a case after liver transplantation and review of the literature. Transplant Infectious Disease. 2011;13(1):63–69. - PubMed

LinkOut - more resources