Mycobacterium Kansasii Infection Overlying Tattoo Pigment in an Immunocompromised Patient

Rohit Gupta,Carina Wasko,Jennifer Martin

doi:10.25251/skin.4.6.17

Abstract

The incidence of atypical mycobacterial infections has steadily grown over the past decades, and it is well-known that the risk of progressive disease increases with immunodeficiency. While rare, tattoo pigment can serve as a nidus for atypical mycobacterium infection in immunocompromised individuals. Here, we present a case of a 41-year-old immunocompromised female who presented with verrucous plaques overlying long-standing tattoos in multiple locations. The patient’s lesions were biopsied and sent for board-range polymerase chain reaction revealing infection with Mycobacterium kansasii, a slow-growing atypical mycobacterium that rarely causes cutaneous disease without systemic symptoms. Early recognition and treatment of cutaneous M. kansasii is important to prevent progression of disease.

Highlights

INTRODUCTIONMycobacterium tuberculosis and Mycobacterium leprae.[1]. The incidence of these infections has steadily grown over the past decades, and it is well-known that the risk of progressive disease increases with immunodeficiency.[2]
Atypical mycobacterium infections are those caused by mycobacteria other thanMycobacterium tuberculosis and Mycobacterium leprae.[1]
This may lead to progression of disease; it is imperative that providers maintain clinical suspicion of atypical mycobacterium infections among immunocompromised patients and be familiar with presentations of disease

Summary

INTRODUCTION

Mycobacterium tuberculosis and Mycobacterium leprae.[1]. The incidence of these infections has steadily grown over the past decades, and it is well-known that the risk of progressive disease increases with immunodeficiency.[2]. A 41-year-old African American woman presented to the emergency department for a 3-month history of progressive and painful skin lesions on her extremities. During her evaluation, she was noted to have verrucous papules and nodules coalescing into plaques within the tattoos on her right forearm and left shin (Figure 1). She was noted to have verrucous papules and nodules coalescing into plaques within the tattoos on her right forearm and left shin (Figure 1) She reported that the tattoos were obtained from different tattoo parlors years ago. Azithromycin was added back to the treatment regimen given concern for rifampin-resistance, and the patient was documented to have improvement at the two month follow-up

DISCUSSION

CONCLUSION