Atypical Mycobacteriosis and Pitfalls of its Therapy


Authors: M. Bodnárová 1;  J. Štork 1;  M. Kojanová 1;  P. Ježek 2;  V. Fišerová 2;  M. Havelková 3;  I. Pavlík 4
Authors‘ workplace: Dermatovenerologická klinika 1. LF UK a VFN, Praha přednosta prof. MUDr. J. Štork, CSc. 1;  Oddělení klinické mikrobiologie a parazitologie, Oblastní nemocnice Příbram a. s. přednosta prim. MVDr. Petr Ježek 2;  NRL pro mykobakerie, SZÚ Praha vedoucí MUDr. Marta Havelková, CSc. 3;  Referenční laboratoř pro paratuberkulózu a aviární tuberkulózu Výzkumný ústav veterinárního lékařství, Brno vedoucí prof. MVDr. Ivo Pavlík, CSc. 4
Published in: Čes-slov Derm, 83, 2008, No. 6, p. 305-309
Category: Case Reports

Overview

Atypical mycobacteriosis (also called mycobacteriosis) is a non-tuberculous mycobacterial infection caused by opportunistic pathogenic species of mycobacteria. The case of 53-year-old woman with rare sporotrichoid form of skin infection caused by injury after the contact with aquarium fish followed by formation of multiple nodules with abscesses is presented. Histological examination supported the diagnosis of mycobacteriosis. After four months of unsuccessful antimicrobial therapy the causative agent Mycobacterium marinum was isolated. The patient was treated for eleven months with combined antibacterial therapy with ciprofloxacin and ethambutol based on the agent drug sensitivity on cultivation and surgical excisions of small persistent lesions. Difficulties in diagnostics and therapy, often due to failed isolation of the causative agent, are presented. Optimal targeted therapy is based on the sensitivity of isolated strain to antituberculotic and other antibacterial agents.

Key words:
atypical mycobacteriosis – sporotrichoid form – Mycobacterium marinum – diagnosis – targeted therapy


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Labels
Dermatology & STDs Paediatric dermatology & STDs
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