Ann Dermatol.  2014 Feb;26(1):92-95. 10.5021/ad.2014.26.1.92.

Cutaneous Mycobacterium massiliense Infection of the Sole of the Feet

• Jung MY
• Lee JH
• Kim CR
• Kim HJ
• Koh WJ
• Ki CS
• Lee JH
• Yang JM
• Lee DY

• KMID: 2265703
• DOI: http://doi.org/10.5021/ad.2014.26.1.92

Abstract

Mycobacterium massiliense which is recognized as a separate species from M. abscessus is little known regarding its clinical patterns and the response to treatment. We present a case of a localized cutaneous infection due to M. massiliense of the sole associated with acupuncture. M. massiliense was identified via polymerase chain reaction-hybridization analysis. We treated the patient with single-drug therapy consisting of clarithromycin for 4 months and the patient showed a significant response to this treatment.

Keyword

Mycobacterium massiliense

MeSH Terms

Acupuncture
Clarithromycin
Foot*
Humans
Mycobacterium*
Clarithromycin

Figure

• 

  Fig. 1 Erythematous subcutaneous nodule on left sole.

• 

  Fig. 2 (A) Mixed inflammatory cellular infiltration with granuloma in the dermis and subcutaneous layer (H&E, ×100). (B) Multinucleated giant cells are seen in the dermis (H&E, ×400).

• 

  Fig. 3 Ivory-to-yellowish colored smooth colonies on the liquid media at 37℃ after 7 days of culture.

• 

  Fig. 4 Polymerase chain reaction-hydridization. rpoB squences of the isolate (sample no. 1) was identifed as Mycobacterium massiliense (black arrow).

Reference

1. Adékambi T, Reynaud-Gaubert M, Greub G, Gevaudan MJ, La Scola B, Raoult D, et al. Amoebal coculture of "Mycobacterium massiliense" sp. nov. from the sputum of a patient with hemoptoic pneumonia. J Clin Microbiol. 2004; 42:5493–5501.

2. Koh WJ, Jeon K, Lee NY, Kim BJ, Kook YH, Lee SH, et al. Clinical significance of differentiation of Mycobacterium massiliense from Mycobacterium abscessus. Am J Respir Crit Care Med. 2011; 183:405–410.

3. Nakanaga K, Hoshino Y, Era Y, Matsumoto K, Kanazawa Y, Tomita A, et al. Multiple cases of cutaneous Mycobacterium massiliense infection in a "hot spa" in Japan. J Clin Microbiol. 2011; 49:613–617.

4. Cho AY, Kim YS, Kook YH, Kim SO, Back SJ, Seo YJ, et al. Identification of cutaneous Mycobacterium massiliense infections associated with repeated surgical procedures. Ann Dermatol. 2010; 22:114–118.

5. Kim HY, Yun YJ, Park CG, Lee DH, Cho YK, Park BJ, et al. Outbreak of Mycobacterium massiliense infection associated with intramuscular injections. J Clin Microbiol. 2007; 45:3127–3130.

6. Kim BJ, Lee SH, Lyu MA, Kim SJ, Bai GH, Kim SJ, et al. Identification of mycobacterial species by comparative sequence analysis of the RNA polymerase gene (rpoB). J Clin Microbiol. 1999; 37:1714–1720.

7. Kim HY, Kook Y, Yun YJ, Park CG, Lee NY, Shim TS, et al. Proportions of Mycobacterium massiliense and Mycobacterium bolletii strains among Korean Mycobacterium chelonae-Mycobacterium abscessus group isolates. J Clin Microbiol. 2008; 46:3384–3390.

8. Jogi R, Tyring SK. Therapy of nontuberculous mycobacterial infections. Dermatol Ther. 2004; 17:491–498.