Document Detail


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.
MedLine Citation:
PMID:  18717862     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Mycobacterium haemophilum was first recovered from subcutaneous lesions of a patient with Hodgkin's disease. Because of its special growth requirements (it grows at 30-32 degrees C and requires iron-supplemented medium), the organism cannot be isolated using routine culture techniques for other mycobacteria. Only a few developed countries have reported infection with this mycobacterium. We report the first two cases diagnosed in Venezuela. METHODS: The diagnosis of the first case was established using polymerase chain reaction (PCR)-restriction endonuclease analysis of the gene encoding the 65-kDa heat shock protein (hsp65) for the direct identification of M. haemophilum in a clinical specimen in which bacilli were observed on acid-fast smear, but growth was not detected by standard culture procedures. RESULTS: After recognizing this bacterium as a possible cause of infection in our setting, clinical samples of cutaneous lesions were routinely cultured on blood agar at 30 degrees C for at least 6 weeks, which resulted in the diagnosis of the second case. CONCLUSIONS: Dermatologists should consider this bacterium in immunocompromised patients with cutaneous ulcerating lesions. Material from the lesions can be screened for mycobacteria using an acid-fast stain and, if acid-fast bacilli are seen, PCR analysis of mycobacterial hsp65 can be an effective tool for early diagnosis. Appropriate culture methods are required for bacteriologic confirmation of infection with M. haemophilum.
Authors:
Omaira Da Mata; Ricardo Pérez Alfonzo; Ivelisse Natera; Rosibel del Carmen Sucre; Teresita Bello; Jacobus H de Waard
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  International journal of dermatology     Volume:  47     ISSN:  1365-4632     ISO Abbreviation:  Int. J. Dermatol.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-22     Completed Date:  2008-11-17     Revised Date:  2009-03-05    
Medline Journal Info:
Nlm Unique ID:  0243704     Medline TA:  Int J Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  820-3     Citation Subset:  IM    
Affiliation:
Laboratorio de Tuberculosis and Centro Clínico de Dermatología y Enfermedades Tropicales, Instituto de Biomedicina, Universidad Central de Venezuela, Caracas.
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / therapeutic use
Antitubercular Agents / therapeutic use
DNA Restriction Enzymes / diagnostic use*
Drug Therapy, Combination
Female
Follow-Up Studies
Humans
Infant
Middle Aged
Mycobacterium Infections / diagnosis*,  drug therapy
Mycobacterium haemophilum / isolation & purification*
Polymerase Chain Reaction / methods
Restriction Mapping / methods
Risk Assessment
Severity of Illness Index
Skin Ulcer / diagnosis*,  drug therapy,  microbiology
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Antitubercular Agents; EC 3.1.21.-/DNA Restriction Enzymes

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