Mycobacterium haemophilum Infection

Updated: Dec 03, 2019
  • Author: Shirin A Mazumder, MD, FIDSA; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
  • Print
Overview

Background

Mycobacterium haemophilum is a nontuberculous mycobacterium that causes skin, joint, bone, and pulmonary infections in immunocompromised persons and lymphadenitis in children. [1, 2]

M haemophilum was first isolated from subcutaneous abscesses in a patient with Hodgkin disease. Most recent infections have occurred in patients with AIDS, in transplant recipients, and in patients receiving tumor necrosis factor-alpha inhibitors. [3, 4, 5] M haemophilum skin infection has been associated with permanent eyebrow makeup and tattoos, [6] as well as acupuncture treatments. [7]

M haemophilum is a fastidious (requires special growth media) mycobacterium that requires heme-supplemented culture media and low temperatures for growth. Because of these features, it is probably underdiagnosed.

Next:

Pathophysiology

The pathophysiology, natural habitat, and mechanism for acquisition of M haemophilum infection are not known. Water reservoirs may be the source of M haemophilum infections. Immunocompromised adults with M haemophilum infection most commonly present with skin lesions. Septic arthritis and osteomyelitis may also occur. Pulmonary infection is much less common and may follow skin disease. M haemophilum infection occasionally causes pulmonary infection initially. Mycobacteremia may occur.

Previous
Next:

Epidemiology

Frequency

United States

More than 40 cases of M haemophilum infection have been reported, including 10 cases in Arizona from 1984-1994. Most cases occurred in immunosuppressed patients. The incidence of disease is unknown.

International

Cases of M haemophilum infection have been reported sporadically from Australia, France, Germany, [8] Canada, Israel, United Kingdom, and South Africa.

Mortality/Morbidity

In healthy children, localized cervical lymphadenopathy is a benign disease that responds well to excision of the involved lymph nodes.

In immunocompromised patients, the outcome of disease is determined by the degree of underlying immunosuppression. Some patients with AIDS respond to therapy, while others respond initially but relapse later. Fatalities have occurred in bone marrow transplant recipients.

Sex

M haemophilum infection is more common in males than in females. This may be related to the higher incidence of HIV infection in males.

Age

Lymphadenitis occurs in young children.

Most cases in immunocompromised patients occur in adults.

Previous
Next:

Prognosis

Prognosis for children with localized lymphadenitis is good.

In adults, the outcome is determined by their immune function.

In severely immunosuppressed patients, disease may require long-term therapy. Despite maintenance therapy, infection may persist or recur.

Previous
Next:

Patient Education

Adherence to medication is of utmost importance to prevent resistance.

Instruct patients to list all medications to avoid drug interactions.

Rifampin and rifabutin may interfere with contraceptives and numerous other medications, especially HIV-related therapy.

Previous