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Original ArticleOpen Access
Nontuberculous Mycobacterial Skin Infections : Clinical and Bacteriological Studies
MD PM 
,
Chaiprasert A ,
rer D ,
Manonukul MJ ,
Gengviniij MN ,
Ubol PN ,
BSc SP
,
Chaiprasert A ,
rer D ,
Manonukul MJ ,
Gengviniij MN ,
Ubol PN ,
BSc SP ANGKANA CHAIPRASERT, Dr rer nat**
JANE MANONUKUL, MD***,
PREY A WIS NA UBOL, BSc**,
Objective
: Nontuberculous mycobacterial (NTM) skin infections were analysed in terms
of clinical manifestation in different species to provide clues for the clinical diagnosis and sensitivity
patterns of these species were studied for planning appropriate therapy.
Design
: A retrospective study was performed in 123 suspected cases of NTM infections
from January 1994 to December 2000. NTM infection was documented by culture result of the infected
tissue obtained by skin biopsy. Drug susceptibility test was done as requested.
Result:
Rapid growers
(M.fortuitum-chelonae)
were found in 26 cases (65%) and
M. marinum
was responsible for 12 cases (30%) and caused only localized skin lesions on arms or legs as indurated
plague, Disseminated skin infections manifested as multiple abscesses were found in 2 cases caused
by
M. avium
in an HIV -infected male patient and mixed infection of
M. szulgai
and
M. terrae
in an
immunocompetent female patient after a dental procedure. Both sexes were affected equally in overall
number but male predominated in
M. marinum
infection and females predominated in rapid growers.
All ages can be affected but most cases were middle aged. Scrofuloderma -like cervical lympha-
denitis and cutaneous abscesses were the common manifestation of rapid grower infections. Hyper-
keratotic verrucous plagues (tuberculosis verrucosa cutis -like) and sporotrichoid lesions were the
common manifestations of
M. marinum
infection.
M. marinum
is sensitive to minocyclin, clarithro-
mycin, amikacin, rifampicin and ethambutol and a good clinical response was obtained with doxy-
cyclin 100 mg orally twice a day for 3 months. Clarithromycin and amikacin showed
in vitro
activity
against the same strain of
M. fortuitum
but most strains of rapid growers resisted antituberculous
drugs and also various antibiotics.
Vol. 86 No.1
NONTUBERCULOUS MYCOBACTERIAL SKIN INFECTION
53
Conclusion : Clinical manifestations can be used as clues for diagnosis. Medical therapy
is recommended forM.
marinum
infection and surgical treatment is recommended for rapid growers.
Key word : Nontuberculous Mycobacterial Skin Infections, Clinical Study, Bacteriologic Study,
Sensitivity Patterm
JANE MANONUKUL, MD***,
PREY A WIS NA UBOL, BSc**,
Objective
: Nontuberculous mycobacterial (NTM) skin infections were analysed in terms
of clinical manifestation in different species to provide clues for the clinical diagnosis and sensitivity
patterns of these species were studied for planning appropriate therapy.
Design
: A retrospective study was performed in 123 suspected cases of NTM infections
from January 1994 to December 2000. NTM infection was documented by culture result of the infected
tissue obtained by skin biopsy. Drug susceptibility test was done as requested.
Result:
Rapid growers
(M.fortuitum-chelonae)
were found in 26 cases (65%) and
M. marinum
was responsible for 12 cases (30%) and caused only localized skin lesions on arms or legs as indurated
plague, Disseminated skin infections manifested as multiple abscesses were found in 2 cases caused
by
M. avium
in an HIV -infected male patient and mixed infection of
M. szulgai
and
M. terrae
in an
immunocompetent female patient after a dental procedure. Both sexes were affected equally in overall
number but male predominated in
M. marinum
infection and females predominated in rapid growers.
All ages can be affected but most cases were middle aged. Scrofuloderma -like cervical lympha-
denitis and cutaneous abscesses were the common manifestation of rapid grower infections. Hyper-
keratotic verrucous plagues (tuberculosis verrucosa cutis -like) and sporotrichoid lesions were the
common manifestations of
M. marinum
infection.
M. marinum
is sensitive to minocyclin, clarithro-
mycin, amikacin, rifampicin and ethambutol and a good clinical response was obtained with doxy-
cyclin 100 mg orally twice a day for 3 months. Clarithromycin and amikacin showed
in vitro
activity
against the same strain of
M. fortuitum
but most strains of rapid growers resisted antituberculous
drugs and also various antibiotics.
Vol. 86 No.1
NONTUBERCULOUS MYCOBACTERIAL SKIN INFECTION
53
Conclusion : Clinical manifestations can be used as clues for diagnosis. Medical therapy
is recommended forM.
marinum
infection and surgical treatment is recommended for rapid growers.
Key word : Nontuberculous Mycobacterial Skin Infections, Clinical Study, Bacteriologic Study,
Sensitivity Patterm
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