|LETTER TO EDITOR
|Year : 1996 | Volume
| Issue : 2 | Page : 133-134
Gurcharan Singh, AK Malik, Praveen Rodrigues
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Singh G, Malik A K, Rodrigues P. Sporotrichoid mycobacteriosis. Indian J Dermatol Venereol Leprol 1996;62:133-4
| To the Editor,|| |
Reports on atypical mycobacterial infection of skin have been appearing with increasing frequency in medical literature. The majority are description of solitary granulomatous lesions of skin. However in several instances lesions developed in an ascending proximal fashion strongly suggesting sporotrichosis., We report one such case of sporotrichoid mycobacteriosis.
A 37-year-old serving soldier presented with complaints of multiple nodules over right forearm of 6 months duration, appearing 3 weeks following trauma to right index finger. He had received pefloxacin therapy for a month, 3 months prior to presentation resulting in partial and temporary resolution of skin lesion. His trade involved grooming horses with history of frequent contact with mud and water. No significant past or family history was elicited.
General, physical and systemic examination revealed no abnormality. Dermatological examination revealed multiple, crusted erythematous mildly tender and indurated nodules and plaques varying in size from 0.5 to 3.0 cm in diameter in a linear distribution over extensor aspect of right forearm [Figure - 1]. No lymphatic cords or regional lymph nodes were palpable.
Routine haemogram, urinalysis, blood sugar, LFT and serum ceratinine were within normal limits, ESR was 15mm/lst hour, Mantoux test was positive (16mm). Blood STS and ELISA for HIV were nonreactive. Skin biopsy revealed dense mononuclear infiltrate in upper dermis with few Langhans type of giant cells. No AFB, fungus or LD bodies were seen. Cultures for fungus, Mycobacterium tuberculosis and atypical mycobacteria showed no growth. Complete resolution of skin lesions was evident after 3 months of minocycline therapy, which is efficaceous in atypical mycobacterial infections.
Appearance of lesions in a sporotrichoid pattern following trauma, histopathological features, and response to minocycline therapy in a person coming in frequent contact with mud and water is suggestive of atypical mycobacterial (M marinum) infection in this case. Failure to culture organism could be due to pefloxacin therapy received prior to presentation, as quinolones are documented to have activity against atypical mycobacteria.
| References|| |
|1.||Huminer D, Pitlik SD, Block C, et al. Aquarium-borne Mycobacterium marinum skin infection. Arch Dermatol 1986;122:698-703. [PUBMED] |
|2.||Dickey RF. Sporotrichoid mycobacteriosis caused by M marinum (balnei). Arch Dermatol 1968;98:385-91. [PUBMED] |
|3.||Owens DW, McBride ME. Sporotrichoid cutaneous infection with Mycobacterium kansasii. Arch Dermatol 1969;100:54-8. [PUBMED] |
|4.||Loria PR. Minocycline hydrochloride teratment for atypical acid-fast infection. Arch Dermatol 1976;517-9. |
|5.||Quinolone antibacterials. An update on their pharmacology and therapeutic use. Drugs 1994;47:877. |
[Figure - 1]