Cutaneous infection due to a rough variant of Mycobacterium marinum.
Spreading lesions clinically resembling lymphangitic sporotrichosis developed on the right arm and chest of a 60-year-old man with chronic lymphocytic leukemia. Acid-fast bacilli were seen in exudates from lesions and in biopsies, and were cultured from them. The isolant grew initially as a yellowish-orange scotochromogen on Lowenstein-Jensen medium at room temperature and at 35 C., but failed to grow at 37 C. It failed to grow on 7-H-10 medium. On repeated subculturing over a 2-year period it gradually converted to a photochromogen. Histologically, there was ulceration with extensive acute and chronic inflammation with fibrosis. Organisms occurred intracellularly as dense, compact, cigar-like packets resembling lepara bacilli. The appeared to have a predilection for the nucleus. The patient was anergic to PPD S, B, Y and G, and lacked antibodies to BCG phosphoglycolipids. The mycobacteriosis was alleviated by combined INH and ethambutol therapy. The isolant was identified as a rough variant of Mycobacterium marinum. It may have been transmitted by an insect vector.
D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001500:BCG Vaccine; D001431:Bacteriological Techniques; D002467:Cell Nucleus / Q000382:microbiology; D003470:Culture Media; D006801:Humans; D007945:Leukemia, Lymphoid / Q000150:complications; D008297:Male; D008875:Middle Aged; D009161:Mycobacterium / Q000254:growth & development / Q000276:immunology / Q000302:isolation & purification* / Q000378:metabolism; D009163:Mycobacterium bovis / Q000276:immunology; D009336:Necrosis; D010860:Pigments, Biological / Q000096:biosynthesis; D012867:Skin / Q000648:ultrastructure; D013696:Temperature; D014382:Tuberculosis, Cutaneous / Q000150:complications / Q000382:microbiology* / Q000473:pathology
D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001500:BCG Vaccine; D003470:Culture Media; D010860:Pigments, Biological