Mycobacterium Fortuitum Clinical Presentation

  • Author: Joseph M Fritz, MD; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Feb 26, 2010
 

History

  • Patients with skin disease may develop a nonhealing but nonspreading wound or skin ulcer.
  • Patients with lung disease may develop a chronic cough.
  • Pulmonary and disseminated disease cause easy fatigability, occasional fever, night sweats, and weight loss. These symptoms are less common with M fortuitum infection than with tuberculosis.
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Physical

No findings are pathognomonic of M fortuitum infection. Physical findings depend on the infection site.

  • Eye: Keratitis or corneal ulcers may be present.
  • Lungs: Rales or rhonchi may be present.
  • Heart: Valvular murmur with endocarditis may be present.
  • Abdomen: Diffuse tenderness with peritonitis may be present (eg, a patient undergoing peritoneal dialysis).
  • Skin: Ulcerative skin lesions and/or subcutaneous nodules may be present. Deeper infections may lead to draining fistulas.
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Causes

  • Trauma or injection - Skin lesions, subcutaneous lesions, ocular lesions, and osteomyelitis
  • Immunosuppression - Disseminated disease, especially in patients with AIDS or in those who use corticosteroids
  • Lung disease – Bronchiectasis
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Contributor Information and Disclosures
Author

Joseph M Fritz, MD  Fellow, Division of Infectious Diseases, Washington University School of Medicine, Barnes Jewish Hospital

Joseph M Fritz, MD is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of America, and Society for Healthcare Epidemiology of America

Disclosure: Nothing to disclose.

Coauthor(s)

Keith F Woeltje, MD, PhD  Associate Professor, Department of Internal Medicine, Division of Infectious Diseases, Washington University School of Medicine

Keith F Woeltje, MD, PhD is a member of the following medical societies: American College of Physicians, American Medical Informatics Association, Infectious Diseases Society of America, and Society for Healthcare Epidemiology of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Klaus-Dieter Lessnau, MD, FCCP  Clinical Associate Professor of Medicine, New York University School of Medicine; Medical Director, Pulmonary Physiology Laboratory; Director of Research in Pulmonary Medicine, Department of Medicine, Section of Pulmonary Medicine, Lenox Hill Hospital

Klaus-Dieter Lessnau, MD, FCCP is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Medical Association, American Society for Artificial Internal Organs, American Thoracic Society, Physicians for Social Responsibility, and Society of Critical Care Medicine

Disclosure: sepracor None None

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Aaron Glatt, MD  Professor of Clinical Medicine, New York Medical College; President and CEO, Former Chief Medical Officer, Departments of Medicine and Infectious Diseases, New Island Hospital

Aaron Glatt, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physician Executives, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Medical Association, American Society for Microbiology, American Thoracic Society, American Venereal Disease Association, Infectious Diseases Society of America, International AIDS Society, and Society for Healthcare Epidemiology of America

Disclosure: Nothing to disclose.

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

References

  1. Winthrop KL, Abrams M, Yakrus M, Schwartz I, Ely J, Gillies D, et al. An outbreak of mycobacterial furunculosis associated with footbaths at a nail salon. N Engl J Med. May 2 2002;346(18):1366-71. [Medline].

  2. CDC. Nontuberculous mycobacteria reported to the Public Health Laboratory Information System by State Public Health Laboratories United States, 1993-1996. [Full Text].

  3. ATS. Diagnosis and treatment of disease caused by nontuberculous mycobacteria. This official statement of the American Thoracic Society was approved by the Board of Directors, March 1997. Medical Section of the American Lung Association. Am J Respir Crit Care Med. Aug 1997;156(2 Pt 2):S1-25. [Medline].

  4. Wallace RJ, Swenson JM, Silcox VA, Bullen MG. Treatment of nonpulmonary infections due to Mycobacterium fortuitum and Mycobacterium chelonei on the basis of in vitro susceptibilities. J Infect Dis. Sep 1985;152(3):500-14. [Medline].

  5. Heifets LB. Antimycobacterial drugs. Semin Respir Infect. Jun 1994;9(2):84-103. [Medline].

  6. Brown-Elliott BA, Wallace RJ, Crist CJ. Comparison of in vitro activities of gatifloxacin and ciprofloxacin against four taxa of rapidly growing mycobacteria. Antimicrob Agents Chemother. Oct 2002;46(10):3283-5. [Medline].

  7. Wallace RJ, Brown-Elliott BA, Crist CJ. Comparison of the in vitro activity of the glycylcycline tigecycline (formerly GAR-936) with those of tetracycline, minocycline, and doxycycline against isolates of nontuberculous mycobacteria. Antimicrob Agents Chemother. Oct 2002;46(10):3164-7. [Medline].

  8. ATS/IDSA: Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F, et al. An Official ATS/IDSA Statement: Diagnosis, Treatment, and Prevention of Nontuberculous Mycobacterial Diseases. Am J Respir Crit Care Med. February 2007;175:367-416. [Medline].

  9. Bhambri S, Bhambri A, Del Rosso JQ. Atypical mycobacterial cutaneous infections. Dermatol Clin. Jan 2009;27(1):63-73. [Medline].

  10. Esteban J, Ortiz-Pérez A. Current treatment of atypical mycobacteriosis. Expert Opin Pharmacother. Dec 2009;10(17):2787-99. [Medline].

  11. Griffith DE, Wallace RJ. New developments in the treatment of nontuberculous mycobacterial (NTM) disease. Semin Respir Infect. Dec 1996;11(4):301-10. [Medline].

  12. Kyle SD, Porter WM. Mycobacterium chelonae infection successfully treated with oral clarithromycin and linezolid. Br J Dermatol. Nov 2004;151(5):1101. [Medline].

  13. Porat MD, Austin MS. Bilateral knee periprosthetic infection with Mycobacterium fortuitum. J Arthroplasty. Aug 2008;23(5):787-9. [Medline].

  14. Wagner D, Young LS. Nontuberculous mycobacterial infections: a clinical review. Infection. Oct 2004;32(5):257-70. [Medline].

  15. Wallace RJ, Brown-Elliott BA, Ward SC. Activities of linezolid against rapidly growing mycobacteria. Antimicrob Agents Chemother. Mar 2001;45(3):764-7. [Medline].

 
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