Vaishnavi Gowda
Amrita Institute Of Medical Sciences
Title: Atypical mycobacterial cutaneous infections: A 5 years retrospective study
Biography
Biography: Vaishnavi Gowda
Abstract
Atypical mycobacteria comprise a heterogeneous non-tuberculous group of acid-fast bacteria involving the skin. The aim of our study was to describe the clinical and pathological features and species profile of atypical mycobacteria with a special mention to treatment response. A retrospective-record based study of patients attending our hospital over the past 5-years was carried out. Of the 3,45,456 patients 33 cases (19 male, 14 female) of atypical mycobacterial cutaneous infections were diagnosed. Patients’ age ranged from 21-75 years and average duration of lesions was 15 months. The diagnosis was proved by direct smear (6.5%), skin biopsy (20.9%), tissue culture (47.8%) and polymerase chain reaction (24.8%). Gene xpert was also carried out in a few cases. All biopsies revealed granulomatous inflammation. The most common organism isolated was Mycobacterium marinum(84.8%) ,with the upper limb being the commonest site. Other species isolated included Mycobacterium fortuitum(10.9%) and Mycobacterium kansasii(4.3%). 32 patients received treatment and 31 responded. 26 patients were treated with oral tetracyclines. Duration of treatment ranged from 8 to 54 weeks. Cutaneous atypical mycobacterial infections are showing a rising trend with Mycobacterium marinum showing highest prevalence. Newer technologies like polymerase chain reaction and gene xpert provide a rapid and sensitive method to improve the diagnosis. Tetracycline group of antibiotics, especially minocycline is effective in cases caused by Mycobacterium marinum. Combination chemotherapy may be a better choice for infections caused by other species.