Soft Tissue Infection with Mycobacterium abscessus on the Chin of a Healthy Child: A Case Report

건강한 소아의 턱에 발생한 Mycobacterium abscessus에 의한 연부조직 감염: 증례 보고

  • Kim, Hong-Ryul (Department of Plastic Surgery, Korea University College of Medicine) ;
  • Kim, Deok-Woo (Department of Plastic Surgery, Korea University College of Medicine)
  • 김홍렬 (고려대학교 의과대학 성형외과학교실) ;
  • 김덕우 (고려대학교 의과대학 성형외과학교실)
  • Received : 2009.06.12
  • Accepted : 2010.04.07
  • Published : 2010.05.10

Abstract

Purpose: Mycobacterium abscessus belongs to the group of rapid-growing atypical mycobacterium. The organism is ubiquitous and is found in soil, dust, and water. Although it rarely causes disease in humans, Mycobacterium abscessus has been associated with soft tissue infection. To the best of our knowledge, this is the first case report of facial soft tissue Mycobacterium abscessus infection in a healthy child in Korea. Methods: A 12-year-old girl presented with an erythematous skin lesion with serous discharge on her chin, which had been present for 3 weeks. On her history, she had a laceration wound on her chin at public bath and the lesion was repaired at emergency department immediately. Although conventional soft tissue infecton treatment, her lesion remains unhealed state and had serous discharge for 2 months. Moreover, we found a 1 cm sized nodular mass on her chin. Therefore we performed excision operation and referred the specimen to the laboratory for microbial and histopathologic study. Results: Pathology report confirmed the mass was enlarged lymph node with chronic necrotizing granulomatous inflammation with central microabscess. Non-Tuberculous mycobacterium identification test through tissue specimen resulted Mycobacterium abscessus. We prescribed clarithromycin for three weeks by oral administration as well as performed wound debridement and mass excision via previous wound. This way, her lesion appeared to be complete healing with minimal scarring. There were no evidence of inflammation sign or palpable mass. Conclusion: Although the prevalence is rare, Mycobacterium abscessus infections of soft tissue should be considered even in a healthy child with a lesion caused by trauma or which fails to respond to conventional treatment.

Keywords

References

  1. Escalonilla P, Esteban J, Soriano mL, Farina MC, Pigu E, Grilli R, Ramirez JR, Barat A, Martin L, Requena L: Cutaneous manifestations of infection by nontuberculous mycobacteria. Clin Exp Dermatol 23: 214, 1998 https://doi.org/10.1046/j.1365-2230.1998.00359.x
  2. Sastry V, Brennan PJ: Cutaneous infections with rapidly growing mycobacteria. Clin Dermatol 13: 266, 1995
  3. Petrini B: Mycobacterium abscessus: An emerging rapidgrowing potential pathogen. APMIS 114: 319, 2006 https://doi.org/10.1111/j.1600-0463.2006.apm_390.x
  4. Tang P, Walsh S, Murray C, Alterman C, Varia M, Broukhanski G, Chedore P, DeKoven J, Assaad D, Gold WL, Ghazarian D, Finkelstein M, Pritchard M, Yaffe B, Jamieson F, Henry B, Phillips E: Outbreak of acupuncture-associated cutaneous Mycobacterium abscessus infections. J Cutan Med Surg 10: 166, 2006 https://doi.org/10.2310/7750.2006.00041
  5. Weizul S, Eichhorn PJ, Pandya AG: Nontuberculous mycobacterial infections of the skin. Dermatol Clin 18: 359, 2000 https://doi.org/10.1016/S0733-8635(05)70182-0
  6. Ahn HC, Baik EH, Oh JK, Sung KY: Facial skin tuberculosis by Mycobacterium abscessus. J Korean Soc Plast Reconstr Surg 33: 127, 2006
  7. Brantley JS, Readinger AL, Morris ES: Cutaneous infections with Mycobacterium abscessus in a child. Pediatr Dermatol 23: 128, 2006 https://doi.org/10.1111/j.1525-1470.2006.00196.x
  8. Toy BR, Frank PJ: Outbreak of Mycobacterium abscessus infection after soft tissue augmentation. Dermatol Surg 29: 971, 2003 https://doi.org/10.1046/j.1524-4725.2003.29262.x