Mycobacterium chelonae Is an Ubiquitous Atypical Mycobacterium.
The type of cutaneous infection varies mainly according to the patient's immune status, and the disseminated form is mostly found in the context of immunosuppression. We report the case of a 62-year-old male who was under long-term systemic corticosteroid therapy and presented with a 7-month history of multiple painless cutaneous lesions at various stages of development: papules, nodules, pustules and hemorrhagic crusts, as well as small erosions and ulcers distributed over the limbs and scalp. Cutaneous biopsy showed a suppurative granulomatous infiltrate with abscess formation. Fite stain revealed numerous extracellular bacilli, suggesting mycobacterial infection, particularly by atypical mycobacteria. Culture of a skin sample revealed Mycobacterium chelonae. The patient started multidrug therapy and showed clinical improvement despite of resistance to one of the antibiotics. This striking presentation underlines the role of immunosuppression with corticotherapy as a major risk factor for these infections. Multidrug therapy is advised and antibiogram is essential in directing treatment.
Dermatology Department, Coimbra University Hospital Centre, Coimbra, Portugal.
Miguel
M
Pinto-Gouveia
Dermatology Department, Coimbra University Hospital Centre, Coimbra, Portugal.
Ana
A
Gameiro
Dermatology Department, Coimbra University Hospital Centre, Coimbra, Portugal.
Leonor
L
Ramos
Dermatology Department, Coimbra University Hospital Centre, Coimbra, Portugal.
José Carlos
JC
Cardoso
Dermatology Department, Coimbra University Hospital Centre, Coimbra, Portugal.
Maria Manuel
MM
Brites
Dermatology Department, Coimbra University Hospital Centre, Coimbra, Portugal.
Óscar
Ó
Tellechea
Dermatology Department, Coimbra University Hospital Centre, Coimbra, Portugal.
Américo
A
Figueiredo
Atypical mycobacteria; Corticosteroid therapy; Immunosuppression; Mycobacterium chelonae