Cutaneous Mycobacterial Infections in Returning Travelers

Abstract

Mexico is one of the most visited tourist destinations in Latin America. In recent years, mycobacterial skin infections in travelers have increased, mainly in Mexico City, Monterrey, Merida, Cancun, and Guadalajara. This study mainly aims to elucidate the modes of transmission and on nonspecific clinical manifestations for making an early diagnosis and preventing severe complications. Non-tuberculous mycobacteria live in our environment. For example, Mycobacterium marinum and Mycobacterium haemophilum are acquired through aquatic exposure; Mycobacterium tuberculosis and Mycobacterium bovis by consumption of contaminated dairy products, fruits, or vegetables, and rapidly growing non-tuberculous mycobacteria are associated with medical tourism and, especially, cosmetic surgery, which is more frequent in women with an average age of 35 years. Clinical manifestations are nonspecific; therefore, the lack of improvement makes us suspect that we are facing a mycobacterial infection. PCR is important to identify the species and provide guidance on the treatment. This condition is increasing owing to the low cost of tourism and cosmetic surgeries. However, complications are hardly ever associated with the procedure per se, but with the patient’s misinformation. Patients do not attend centers with an international accreditation and not receive proper follow-up upon return to their country of origin. Regarding tourism, it is important to implement prevention measures when performing aquatic activities and provide information about sanitary measures for consumer’s protection. Currently, only case reports exist, so it is necessary to establish a mandatory notification registry to understand the prevalence and incidence of each species, which will help in future investigations.