Patel Trisha, Scroggins-Markle Leslie, Kelly Brent
The University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA.
Case Rep Dermatol Med. 2013;2013:149829. doi: 10.1155/2013/149829. Epub 2013 Aug 29.
Background. Dermal piercings have recently become a fashion symbol. Common complications include hypertrophic scarring, rejection, local infection, contact allergy, and traumatic tearing. We report a rare case of Mycobacterium fortuitum following a dermal piercing and discuss its medical implications and treatments. Case. A previously healthy 19-year-old woman presented complaining of erythema and edema at the site of a dermal piercing on the right fourth dorsal finger. She was treated with a 10-day course of trimethoprim-sulfamethoxazole and one course of cephalexin by her primary care physician with incomplete resolution. The patient stated that she had been swimming at a local water park daily. A punch biopsy around the dermal stud was performed, and cultures with sensitivities revealed Mycobacterium fortuitum. The patient was treated with clarithromycin and ciprofloxacin for two months receiving full resolution. Discussion. Mycobacterium fortuitum is an infrequent human pathogen. This organism is a Runyon group IV, rapidly growing nontuberculous mycobacteria, often found in water,soil, and dust. Treatment options vary due to the size of the lesion. Small lesions are typically excised, while larger lesions require treatment for 2-6 months with antibiotics. We recommend a high level of suspicion for atypical mycobacterial infections in a piercing resistant to other therapies.
背景。皮肤穿刺近来已成为一种时尚象征。常见并发症包括肥厚性瘢痕形成、排斥反应、局部感染、接触性过敏和外伤性撕裂。我们报告一例皮肤穿刺后发生偶然分枝杆菌感染的罕见病例，并讨论其医学意义及治疗方法。病例。一名既往健康的19岁女性前来就诊，主诉右手第四指背侧皮肤穿刺部位出现红斑和水肿。她的初级保健医生给予其为期10天的甲氧苄啶 - 磺胺甲恶唑治疗疗程以及一个头孢氨苄疗程，但症状未完全缓解。患者称她每天都在当地水上公园游泳。在皮肤穿刺钉周围进行了打孔活检，培养及药敏试验显示为偶然分枝杆菌。患者接受克拉霉素和环丙沙星治疗两个月后完全康复。讨论。偶然分枝杆菌是一种不常见的人类病原体。该菌属于Runyon IV组，是快速生长的非结核分枝杆菌，常见于水、土壤和灰尘中。治疗方案因病变大小而异。小病变通常采用切除治疗，而大病变则需要使用抗生素治疗2至6个月。对于对其他治疗有抵抗的穿刺部位，我们建议高度怀疑非典型分枝杆菌感染。
