Successful treatment of a unique chronic multi-bacterial scalp infection with N-chlorotaurine, N-bromotaurine and bromamine T

Abstract

Microbial species can act in synergy to circumvent environmental stress conditions and survive. In addition, biofilms are a serious public-health issue globally and constitute a clinical emergency. Infection persistence, increased morbidity and mortality, and antibiotic resistance are consequences of poly-microbial synergy. Due to inherited complexity and synergy between numerous species, newer antimicrobial agents of increased efficacy and tolerability are needed. In this unique medical case, a chronic (9 year) multi-bacterial scalp infection was differentially diagnosed from other inflammatory skin disorders by prolonged microbiological culture. The bacterial species found seem to have caused lesions of visible biofilm not documented previously in the medical literature. This complicated infection was treated successfully and rapidly with the combined topical application of the active halogen compounds N-chlorotaurine, N-bromotaurine and bromamine T, which is in contrast to the previous failed systemic and topical therapeutic approaches. This study strengthens the case for the use of active halogen compounds against multi-bacterial infections of the skin in the future, without the occurrence of resistance.

Keywords: N-bromotaurine; N-chlorotaurine; bromamine T; chronic multi-bacterial skin infection.

Fig. 1.

Treatment of the chronic multi-bacterial infection of the scalp over 60 days with a combination of 1 % NCT, 1 % NBrT and 0.1 % BAT. (a) Lesions growing on the elderly patient’s scalp resembled pustular erosions with eschars. (b) Assuming an infectious origin, some lesions were detached successfully (indicated by an arrow) by using a gauze soaked with a 1 % NCT solution. Tissue and swabs were collected and sent for microbial culture. (c) On day 3, treatment with 1 % NCT showed visible but slow regression of the lesions. Combination therapy with 1 % NCT and 1 % NBrT was commenced. (d) The next day (day 4), the 1 % NCT and 1 % NBrT combination treatment had accelerated the regression and softening of the lesions. (e) By the fifth day of treatment, lesions together with a subcutaneous portion of skin could be partly removed without serious bleeding. Application of 0.1 % BAT twice daily was commenced at home. (f) Evident accelerated tissue repair and almost total clearance of remaining lesions. (g) Wounds were epithelialized, with no evident recurrence of lesions. (h) Further epithelialization of the wounds from the previous lesions. (i) Remarkable epithelialization and tissue repair induced the decision to end the treatments at the clinic. (j) The skin was completely epithelialized and returned to normal pigmentation. Application of 0.1 % BAT was stopped.