P1-34-3 - Disseminated Cutaneous Infection of Mycobacterium Colombiense with Myelodyspalstic Syndrome: a Case Report

Abstract

Mycobacterium colombiense(M.colomboense) belongs to the Mycobacterium avium complex(MAC). It was reported to cause the opportunistic infection of immunocompromised hosts including hematological malignancy. Only a few cases of M. colombiense infection were reported all over the world. This is the first case report of a M. colombiense infection in the immunocompromised host with myelodysplastic syndrome (MDS) in Japan.Case: An 80-years-old man treated for Hypertension and Diabetes mellitus. He developed skin rash with hard exfoliation and eruption on his face and all over his head. The skin biopsy was performed, but initially mycobacterium was not detected. He repeatedly developed systemic inflammation derived from opportunistic infection including pleurapneumonia, so we considered the possibility of immunodeficiency and performed bone marrow aspiration and diagnosed as MDS(RA) with dysfunction of neutrophil. He developed the disseminated impetigos in his limbs and body, and MAC was detected in his pus. The MAC was specified as M.colombiense through Broad-range polymerase chain reaction(PCR). We prescribed the combination of antibiotics, consisting of rifampicin (450mg), ethambutol (750mg), and clarithromycin (800mg) in accordance with nontuberculous mycobacteriosis, and the skin lesions gradually resolved.In conclusion, we reported the first case of M.colombiense infection for immunocomplomised host in Japan and we could diagnose it through Broad-range PCR. The molecular diagnostic methods like PCR can improve the process of identification of the less common bacterial species that may cause persistent opportunistic infections.