Mycobacterium Haemophilum: Background, Pathophysiology, Epidemiology

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Sections Mycobacterium Haemophilum
Overview
Presentation
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Overview

Background

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

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.^{[2, 3, 4]}M haemophilum skin infection has been associated with permanent eyebrow makeup and tattoos,^[5]as well as accupuncture treatments.^[6]

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.

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.

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,^[7]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.

Clinical Presentation

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Natalie C Klein, MD, PhD Associate Director, Infectious Disease Division, Associate Professor of Medicine, The School of Medicine at Stony Brook University Medical Center

Natalie C Klein, MD, PhD is a member of the following medical societies: American College of Physicians, American Society for Microbiology, New York County Medical Society, American Medical Association, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Aaron Glatt, MD Chairman, Department of Medicine, Chief, Division of Infectious Diseases, Hospital Epidemiologist, South Nassau Communities Hospital

Aaron Glatt, MD is a member of the following medical societies: American Association for Physician Leadership, American College of Chest Physicians, 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, Society for Healthcare Epidemiology of America

Disclosure: Nothing to disclose.

Chief Editor

Mark R Wallace, MD, FACP, FIDSA Clinical Professor of Medicine, Florida State University College of Medicine; Clinical Professor of Medicine, University of Central Florida College of Medicine

Mark R Wallace, MD, FACP, FIDSA is a member of the following medical societies: American College of Physicians, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, International AIDS Society, Florida Infectious Diseases Society

Disclosure: Nothing to disclose.

Additional Contributors

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 Thoracic Society, Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Sections Mycobacterium Haemophilum
Overview
Presentation
- History
- Physical
- Causes
- Show All
DDx
Workup
Treatment
Medication
Follow-up
References

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