Disseminated cutaneous infection with Mycobacterium abscessus in a patient with a low CD4+ T cell count.
We report an uncommon case of disseminated cutaneous infection with Mycobacterium abscessus. The patient was a 22-year-old female with low level of CD4+ T cells in the peripheral blood cells, who presented with a number of tender red nodules, erythema and erythematous infiltrated plaques on her cheek, neck and extremities. Colonies without pigment grew after incubating on Löwenstein-Jensen (L-J) medium at 37 degrees C and 32 degrees C for 3-5 days. Polymerase chain reaction (PCR) amplification of the hsp65 gene and the pattern of PCR-restriction fragment length polymorphism (PCR-RFLP) on the isolated strain showed it was M. abscessus. The similarity of hsp65, 16SrRNA gene between the isolate and the M. abscessus reference strain were 99.75% and 100% respectively. After the patient had been treated with rifampin, isoniazid, ofloxacin, clarithromycin and thymosin for 6 months, the skin lesions were greatly improved and the level of CD4+ T cells in the peripheral blood cells became normal.
Wang
Hongsheng
H
Institute of Dermatology, Chinese Academy of Medical Sciences and Peking, Union Medical College, Jiangwangmiao Road 14#, Nanjing 210042, China.
Jin
Peiying
P
Wu
Qinxue
Q
D000328:Adult; D001426:Bacterial Proteins / Q000235:genetics; D018791:CD4 Lymphocyte Count; D018834:Chaperonin 60; D018833:Chaperonins / Q000235:genetics; D004269:DNA, Bacterial / Q000032:analysis; D004275:DNA, Ribosomal / Q000032:analysis; D005260:Female; D006801:Humans; D009165:Mycobacterium Infections, Nontuberculous / Q000276:immunology / Q000382:microbiology* / Q000473:pathology; D009170:Nontuberculous Mycobacteria / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D017192:Skin Diseases, Bacterial / Q000276:immunology / Q000382:microbiology* / Q000473:pathology
D001426:Bacterial Proteins; D018834:Chaperonin 60; D004269:DNA, Bacterial; D004275:DNA, Ribosomal; C074119:heat-shock protein 65, Mycobacterium; D018833:Chaperonins