Skin and Soft Tissue Nontuberculous Mycobacteria Infection: A Retrospective Case Series of 49 Patients.

BACKGROUND

The incidence of skin and soft tissue nontuberculous mycobacteria infection (SSTNI) is increasing. But it may be challenging to diagnose and treat SSTNI.

OBJECTIVE

To summarize course, clinical features, diagnosis and treatment of SSTNI and discuss the association between SSTNI and procedures.

METHODS

A retrospective case series study was conducted among patients diagnosed with SSTNI after surgical procedures. Medical history was collected, disease course and characteristics were analyzed.

RESULTS

49 patients were collected. Among them, 39 (80%) patients were infected with Mycobacterium abscesses. 40 (82%) patients had a history of fat-related procedures. The median and interquartile range of onset time were 15 and 43 days (1-100). Time from first visit to diagnosis was 82±57 days (23-308). Wound healing time was 161±92 days (30-545). The most common symptom were redness (96%), followed by swelling (96%), abscess (84%), pain (80%) and induration (76%). The most common infected site were head and neck (56%), followed by breasts (20%). 6 (12.5%) patients were diagnosed clearly before admission to our department. 10 (28%) patients showed positive acid-fast bacilli (AFB) smears among 36 patients. Treatment included debridement surgeries, drainage and antibiotics.

CONCLUSION

Patient with the above symptoms should be considered as SSTNI. Results of AFB smears are frequently negative after empirical antibiotic treatment so that molecular diagnostic techniques are required for rapid and accurate identification. Debridement surgeries, drainage and sensitive antibiotics are effective. Drug safety and psychological status should be paid attention.

LEVEL OF EVIDENCE IV

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