Información del artículo
Abstract
We report a case of primary cutaneous infection by Mycobacterium haemophilum after the bite of an aquarium fish in a severely immunodepressed AIDS patient. Clinical features consisted in nodular and ulcerative lesions that followed a sporotrichoid pattern. Histological study of nodular lesions showed a granulomatous dermatitis with numerous acid-fast bacilli. The mycobacterium was identified 3 months later by genetic hybridization from a cultive in solid medium. Combined therapy with isoniazid, rifampin, clarithromycin, ethambutol, amikacin and ciprofloxacin resulted in complete resolution of the lesions. Infection by Mycobacterium haemophilum is a rare mycobacteriosis that usually affects immunodepressed patients. The most common clinical manifestations are cutaneous lesions but the development of sporotrichoid nodular lymphangitis is exceptional.
Key words:
Mycobacterium haemophilum
immunosuppression
sporotrichoid
HIV
AIDS
Resumen
Presentamos un caso de infección primaria cutánea por Mycobacterium haemophilum tras la mordedura de un pez de acuario en un paciente con sida, gravemente inmunodeprimido. Las manifestaciones cutáneas consistieron en lesiones nodulares y ulcerativas que seguían un trayecto esporotricoide. El estudio histológico de las lesiones nodulares mostró una dermatitis granulomatosa con numerosos bacilos ácido-alcohol resistentes. La micobacteria se identificó tres meses después mediante hibridación genética a partir de un cultivo en medio sólido. Se instauró terapia combinada con isoniazida, rifampicina, claritromicina, etambutol, amikacina y ciprofloxacino con curación de las lesiones. La infección por Mycobacterium haemophilum es una micobacteriosis poco frecuente que aparece habitualmente en el paciente inmunodeprimido. Las lesiones cutáneas son las manifestaciones clínicas más frecuentes, pero en forma de linfangitis nodular esporotricoide es excepcional.
Palabras clave:
Mycobacterium haemophilum
inmunodepresión
esporotricoide
VIH
sida
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