| 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. | |
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MedLine Citation:
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PMID: 18717862 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Omaira Da Mata; Ricardo Pérez Alfonzo; Ivelisse Natera; Rosibel del Carmen Sucre; Teresita Bello; Jacobus H de Waard |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: International journal of dermatology Volume: 47 ISSN: 1365-4632 ISO Abbreviation: Int. J. Dermatol. Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-08-22 Completed Date: 2008-11-17 Revised Date: 2009-03-05 |
Medline Journal Info:
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Nlm Unique ID: 0243704 Medline TA: Int J Dermatol Country: United States |
Other Details:
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Languages: eng Pagination: 820-3 Citation Subset: IM |
Affiliation:
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Laboratorio de Tuberculosis and Centro Clínico de Dermatología y Enfermedades Tropicales, Instituto de Biomedicina, Universidad Central de Venezuela, Caracas. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anti-Bacterial Agents
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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:
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0/Anti-Bacterial Agents; 0/Antitubercular Agents; EC 3.1.21.-/DNA Restriction Enzymes |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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