title: Eosinophilic Fasciitis associated with Mycoplasma arginini infection.
abstract: Eosinophilic fasciitis (EF) with generalized sclerodermiform skin lesions developed over a 19-month period in a previously healthy 23-year-old man. Although we confirmed EF by skin histology and laboratory tests, the recurrent fevers and the clinical observation of sclerotic prepuce with urethritis indicated further bacteriological analysis by conventional microbiological and DNA-based tests. Urethra cultures were positive for an arginine-hydrolyzing mycoplasma and Ureaplasma urealyticum. The patient also had serum IgM antibodies to Mycoplasma pneumoniae using enzyme-linked immunosorbent assay (ELISA)-based qualitative detection. Mycoplasma arginini was isolated from two independent venous blood serum samples and was identified by conventional microbiological tests and sequencing of the 16S rRNA and rpoB genes (GenBank sequence accession numbers HM179555 and HM179556, respectively). M. arginini genomic DNA also was detected by species-specific PCR in the skin lesion biopsy sample. Treatment with corticosteroids and long-term courses of selected antibiotics led to remission of skin symptoms and normalization of laboratory values. This report provides the first evidence of EF associated with mycoplasma infection and the second report of human infection with M. arginini and therefore suggests that this mycoplasma infection might have contributed to the pathogenesis of the disease.
authors.affiliation: Semmelweis University Hungary, Department of Dermatology, Venereology and Dermatooncology, Budapest, Mária utca 41, Hungary.
authors.forename: Pálma
authors.initials: P
authors.lastname: Silló
authors.forename: Dóra
authors.initials: D
authors.lastname: Pintér
authors.forename: Eszter
authors.initials: E
authors.lastname: Ostorházi
authors.forename: Mercedes
authors.initials: M
authors.lastname: Mazán
authors.forename: Norbert
authors.initials: N
authors.lastname: Wikonkál
authors.forename: Katinka
authors.initials: K
authors.lastname: Pónyai
authors.forename: Dmitriy V
authors.initials: DV
authors.lastname: Volokhov
authors.forename: Vladimir E
authors.initials: VE
authors.lastname: Chizhikov
authors.forename: Susan
authors.initials: S
authors.lastname: Szathmary
authors.forename: Laszlo
authors.initials: L
authors.lastname: Stipkovits
authors.forename: Sarolta
authors.initials: S
authors.lastname: Kárpáti
mesh_terms: D016470:Bacteremia / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology; D015373:Bacterial Typing Techniques; D001706:Biopsy; D001769:Blood / Q000382:microbiology; D016000:Cluster Analysis; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D004275:DNA, Ribosomal / Q000737:chemistry / Q000235:genetics; D004802:Eosinophilia / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D005208:Fasciitis / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology* / Q000473:pathology; D006651:Histocytochemistry; D006801:Humans; D008297:Male; D008969:Molecular Sequence Data; D009174:Mycoplasma / Q000145:classification / Q000302:isolation & purification*; D009175:Mycoplasma Infections / Q000150:complications* / Q000382:microbiology / Q000473:pathology; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012008:Recurrence; D017422:Sequence Analysis, DNA; D017192:Skin Diseases, Bacterial / Q000150:complications* / Q000382:microbiology / Q000473:pathology; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial; D004275:DNA, Ribosomal; D012336:RNA, Ribosomal, 16S