Mycobacterium haemophilum Infection

Updated: Jun 11, 2020
  • Author: Shirin A Mazumder, MD, FIDSA; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Mycobacterium haemophilum is an acid-fast bacillus that has a wide geographic distribution, having been described in many parts of the world, including France, the United Kingdom, Israel, parts of Africa, Australia, Canada, the United States, and Brazil. In addition to infecting humans, M haemophilum has been isolated from the environment and has been found in several animal species. [1]

Distinct from most other nontuberculous mycobacteria, M haemophilum in vitro growth requires a lower incubation temperature and iron supplementation. M haemophilum is unable to synthesize iron-binding siderophores, so it requires iron supplementation to grow in culture. Its preference for lower temperatures, similar to that of Mycobacterium leprae and Mycobacterium marinum, has been associated with a predilection for clinical infections to be located over the extremities. [1]

M haemophilum can cause localized or disseminated infection, usually in individuals with an underlying immunomodulatory condition such as HIV/AIDS, organ transplant recipients, and patients with autoimmune disorders undergoing immunomodulation. The source of M haemophilum is often environmental habitats such as water reservoirs. While most reported cases do not have a clearly identified source, infection in adults has been associated with tattoo parlors and acupuncture needles. [1]



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.




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.


Cases of M haemophilum infection have been reported sporadically from Australia, France, Germany, [2] Canada, Israel, United Kingdom, and South Africa.


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.


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


Lymphadenitis occurs in young children.

Most cases in immunocompromised patients occur in adults.



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.


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.