Infecção cutânea por mycobacterium chelonae numa doente com artrite reumatóide

• Type: Article in International Scientific Journal
• Date: 2010

Authors

Ferreira, O (Author) Other; Duarte, AF (Author) Other; Baudrier, T (Author) Other; Alberto Mota (Author) FMUP; Simoes, JS (Author) Other; Azevedo, F (Author) Other

Journal

Title: Dermatology Online Journal

Vol. 16 No. 1

Final page: 393

ISSN: 1087-2108

Publisher: University of California Press

Indexing

Scopus - 0 Citations

Other information

Authenticus ID: P-00T-4TM

DOI: 10.29021/spdv.70.3.20

Abstract (EN): There are no pathognomonic findings for cutaneous infection caused by Mycobacterium chelonae. The type and duration of therapy varies considerably among reports and no single antibiotic is considered the treatment of choice. A 61-year-old patient, suffering from rheumatoid arthritis (treated with methotrexate and salazopyrine), presented with violaceous nodules of the right leg that had been evolving for 6 months. She was underwent several skin biopsies. Tissue culture of the last showed an atypical mycobacteria, identified as M. chelonae. Despite improvement after a two-week course of treatment with clarithromycin, a switch to ciprofloxacin was made because of gastrointestinal intolerance. After 3 months, only slight improvement of the lesions was achieved and clarithromycin was reintroduced; significant clinical improvement occurred by the third month. Clarithromycin was continued a further two months until the patient quit on her own and no recurrence was observed. Infections caused by M. chelonae frequently occur in the setting of immunological impairment. Contaminated water is the natural reservoir, but we were unable to establish the source of contamination. As was previously described, there was a significant delay between clinical presentation and diagnosis. Thus, a high index of suspicion and multiple biopsies with culture are of paramount importance to confirming the diagnosis. © 2010 Dermatology Online Journal.

Language: English

Type (Professor's evaluation): Scientific