Foti Caterina, Sforza Vincenza, Rizzo Caterina, De Pascale Giovanna, Bonamonte Domenico, Conserva Anna, Tarantino Antonio, Stella Camilla, Cantore Stefania, Grassi Roberto Felice, Ballini Andrea, De Vito Danila, Angelini Giovanni
Department of Internal Medicine, Immunology and Infectious Diseases, Unit of Dermatology, University of Bari, Bari, Italy.
Cases J. 2009 Jul 31;2:6828. doi: 10.1186/1757-1626-0002-0000006828.
Mycobacterium gordonae is one of the least pathogenic of the mycobacteria. This pathogen may produce caseating or non-caseating granulomas, and skin lesions showing acute or chronic inflammation with scattered histiocytes and giant cells have been seen. The mortality rate is less than 0.1%. Mycobacterium gordonae may be a marker of severe immunosuppression in patients infected with human immunodeficiency virus.
We report a case of Mycobacterium gordonae infection in an 86-year-old woman and discuss the problems inherent to the identification and treatment of this emerging pathogen. Mycobacterium gordonae strain we isolated was resistant to trimethoprim-sulfamethoxazole but sensitive to ciprofloxacin, and long term administration (six months) induced complete healing of the cutaneous abscesses.
Advanced laboratory diagnostic techniques have improved the isolation and identification of nontuberculous mycobacteria. The diagnosis requires a high index of clinical suspicion, as detection by conventional methods is difficult. To our knowledge, this patient is the first documented case of cutaneous infection from this pathogen in Italy.
戈登分枝杆菌是致病性最低的分枝杆菌之一。该病原体可产生干酪样或非干酪样肉芽肿,并且已观察到皮肤病变表现为急性或慢性炎症,伴有散在的组织细胞和巨细胞。死亡率低于0.1%。戈登分枝杆菌可能是感染人类免疫缺陷病毒患者严重免疫抑制的一个标志。
我们报告一例86岁女性戈登分枝杆菌感染病例,并讨论这种新出现病原体的鉴定和治疗所固有的问题。我们分离出的戈登分枝杆菌菌株对复方新诺明耐药,但对环丙沙星敏感,长期给药(六个月)使皮肤脓肿完全愈合。
先进的实验室诊断技术提高了非结核分枝杆菌的分离和鉴定。由于传统方法难以检测,诊断需要高度的临床怀疑。据我们所知,该患者是意大利首例有文献记载的由该病原体引起的皮肤感染病例。