Abstract
A growing number of nontuberculous mycobacteria infection cases, especially those caused by rapidly growing mycobacteria (RGM), have been reported in the past decade. Conventional methods for mycobacteria diagnosis are inefficient and easily lead to misdiagnosis. New detection methods, such as gene sequencing, have been reported but are not widely used. The aim of the present case report was to provide a quick and exact method of identifying Myobacterium abscessus (M. abscessus) infections. The particular case reported in this study initially manifested as hyperglycemia and papules in the right leg. Routine cultures for fungus were repeatedly negative. However, cultures of the purulent material under aerobic cultivation for five days yielded a rapidly growing, nontuberculous mycobacterium. A Ziehl-Neelsen staining of this mycobacterium revealed the presence of acid-fast bacilli that were finally identified as M. abscessus through 16S rDNA sequence analysis and a citrate utilization test. The current report may help other clinicians to make a quick and accurate diagnosis of RGM infection.
Highlights
A growing number of nontuberculous mycobacteria infection cases, especially those caused by rapidly growing mycobacteria (RGM), have been reported in the past decade
A case of a skin infection caused by M. abscessus is reported, which was identified by 16S rDNA sequence analysis and the citrate utilization test
There is a difference of only 4 bp (0.37%) in the 16s rDNA between M. abscessus and M. chelonae [7]
Summary
(M. abscessus) and Mycobacterium chelonae (M. chelonae), which are environmental microorganisms present in media including soil, bioaerosols and chlorinated water [1]. A case of a skin infection caused by M. abscessus is reported, which was identified by 16S rDNA sequence analysis and the citrate utilization test. The patient had been impaled by a bamboo pole on the tibialis anterior of the right leg This was followed by the gradual emergence of skin redness, suppuration and ulceration. Direct microscopic examination following Ziehl-Neelsen staining was positive for acid-fast bacilli (Fig. 2) This bacterium grew well on blood, MacConkey, Sabouraud and nutrient agars at 28 ̊C on day five. Following the identification of the microorganism as M. abscessus and susceptibility testing, the patient was discharged on sulfamethoxazole 800 mg twice daily by oral administration for an additional three months. Upon several follow-up visits within one year, the patient maintained a range of healthy blood sugar levels and the cutaneous lesions were gradually eliminated
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