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
Case Reports
. 2014 Dec 1;1(4):e002618.
doi: 10.1099/jmmcr.0.002618. eCollection 2014 Dec.

Cutaneous Mycobacterium haemophilum infections in immunocompromised patients in a tertiary hospital in Bangkok, Thailand: under-reported/under-recognized infection

Thitirat Tangkosakul  1 , Poonpilas Hongmanee  2 , Kumthorn Malathum  3
Affiliations
Case Reports

Cutaneous Mycobacterium haemophilum infections in immunocompromised patients in a tertiary hospital in Bangkok, Thailand: under-reported/under-recognized infection

Thitirat Tangkosakul et al. JMM Case Rep. .

Abstract

Introduction: Mycobacterium haemophilum is one of the non-tuberculous mycobacteria (NTM) that can cause cutaneous infection. As acid-fast staining cannot distinguish NTM from Mycobacterium tuberculosis, and as skin culture for M. haemophilum is not performed routinely, the diagnosis of M. haemophilum infection in Thailand is rarely made.

Case presentation: Between 2006 and 2009, five patients with M. haemophilum infection were diagnosed in Ramathibodi Hospital, a tertiary care centre in Bangkok, Thailand. The patients were aged 3, 29, 47, 75 and 76 years, and four were immunocompromised. Three patients received immunosuppressive medication. Most patients presented with subacute cutaneous infection. A suboptimal response to conventional antibiotics raised suspicions of M. haemophilum cutaneous infections, which can occur in immunocompromised patients. Diagnoses of these cases were made by skin culture for mycobacteria at an incubating temperature of around 30 °C with iron supplementation, DNA sequencing, or PCR/restriction enzyme analysis. Rifampicin, ofloxacin and clarithromycin were active against all isolates, whereas ethambutol and streptomycin were inactive.

Conclusion: Skin culture should be performed under special conditions or molecular technique should be used to identify M. haemophilum in susceptible patients.

Keywords: M. haemophilum; cutaneous infection; iron supplement culture.

PubMed Disclaimer

Figures

Fig. 1.
Fig. 1.. Extensive cellulitis of the legs of one of the patients.
See this image and copyright information in PMC

References

    1. Bernard E.M, Edwards F.F, Kiehn T.E, Brown S.T, Armstrong D.(1993).Activities of antimicrobial agents against clinical isolates of Mycobacterium haemophilum. Antimicrob. Agents Chemother 37, 2323–2326.10.1128/AAC.37.11.2323 - DOI - PMC - PubMed
    1. Chetchotisakd P, Kietiburanakul S, Mootsikapun P, Assanasen S, Chaiwarith R, Anunnatsiri S.(2007).Disseminated nontuberculous mycobacterial infection in patients who are not infected with HIV in Thailand. Clin Infect Dis 45, 421–427.10.1086/520030 - DOI - PubMed
    1. Cheunoy W, Prammananam T, Chaiprasert A, Foongladda S.(2005).Comparative evaluation of polymerase chain reaction and restriction enzyme analysis: two amplified targets, hsp65 and rpoB for identification of cultured mycobacteria. Diagn Microbiol Infect Dis 3, 165–71.10.1016/j.diagmicrobio.2004.09.006 - DOI - PubMed
    1. Da Mata O, Pérez Alfonzo R, Natera I, Sucre Rdel C, Bello T, de Waard J.H.(2008).The diagnosis of two cases of cutaneous ulcer caused by infection with Mycobacterium haemophilum: direct identification in a clinical sample by polymerase chain reaction-restriction endonuclease analysis. Int J Dermatol 47, 820–823.10.1111/j.1365-4632.2008.03702.x - DOI - PubMed
    1. Elsayed S, Read R.(2006).Mycobacterium haemophilum osteomyelitis: case report and review of the literature. BMC Infect Dis 6, 70.10.1186/1471-2334-6-70 - DOI - PMC - PubMed

Publication types

LinkOut - more resources