The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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A Case of Mycobacterium Marinum Tenosynovitis Diagnosed by the PCR-restriction Fragment Length Polymorphism of the rpoB Gene

rpoB 유전자 RFLP에 의한 Mycobacterium Marinum 힘줄윤활막염 진단 1예

  • Chung, Ho-Jung (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Mi-Rae (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Bae, Sun-Youn (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Mi-Yeon (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Chung, Doo-Ryeon (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 정호중 (성균관대학교 의과대학 삼성서울병원 내과) ;
  • 이미래 (성균관대학교 의과대학 삼성서울병원 내과) ;
  • 배선윤 (성균관대학교 의과대학 삼성서울병원 내과) ;
  • 김미연 (성균관대학교 의과대학 삼성서울병원 내과) ;
  • 정두련 (성균관대학교 의과대학 삼성서울병원 내과)
  • Published : 2012.03.01
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Abstract

Mycobacterium marinum is an uncommon cause of skin and soft-tissue infection. The diagnosis of M. marinum infection is often delayed when only a conventional tissue culture method is used. PCR-restriction fragment length polymorphism (RFLP) analysis using the novel region of the rpoB gene is now available for the rapid identification of Mycobacteria. We report a case of hand infection caused by M. marinum that was identified by PCR-RFLP analysis. The PCR-RFLP assay is a specific and rapid method for the identification of Mycobacteria that facilitates the early diagnosis of non-tuberculous Mycobacterium infection.

Mycobacterium marinum 감염증은 드물기도 하거니와 진행이 느려서 진단이 어려워 치료가 지연되는 경우가 흔하다. 진단에는 조직 검사와 조직 배양 검사 결과가 필요하지만, 이는 시간이 오래 걸릴 뿐만 아니라 동정이 쉽지 않아 rpoB gene을 이용한 중합효소연쇄반응-제한효소절편길이다형성 (PCR-RFLP, PRA)을 이용하여 빠르고 간단하게 항산균의 종별 분류가 가능한 방법이 개발되어 있다. 저자들은 이를 이용하여 기존의 방법보다 빠르게 진단하여 치료한 M. marinum에 의한 연부조직 감염 1예를 경험하였기에 보고하는 바이다.

Keywords

References

  1. Holmes GF, Harrington SM, Romagnoli MJ, Merz WG. Recurrent, disseminated Mycobacterium marinum infection caused by the same genotypically defined strain in an immunocompromised patient. J Clin Microbiol 1999;37:3059-3061.
  2. Posteraro B, Sanguinetti M, Garcovich A, et al. Polymerase chain reaction-reverse cross-blot hybridization assay in the diagnosis of sporotrichoid Mycobacterium marinum infection. Br J Dermatol 1998;139:872-876. https://doi.org/10.1046/j.1365-2133.1998.02516.x
  3. Adhikesavan LG, Harrington TM. Local and disseminated infections caused by Mycobacterium marinum: an unusual cause of subcutaneous nodules. J Clin Rheumatol 2008;14:156-160. https://doi.org/10.1097/RHU.0b013e31817759fe
  4. Jernigan JA, Farr BM. Incubation period and sources of exposure for cutaneous Mycobacterium marinum infection: case report and review of the literature. Clin Infect Dis 2000;31:439-443. https://doi.org/10.1086/313972
  5. Lee H, Park HJ, Cho SN, Bai GH, Kim SJ. Species identification of mycobacteria by PCR-restriction fragment length polymorphism of the rpoB gene. J Clin Microbiol 2000;38:2966-2971.
  6. Gluckman SJ. Mycobacterium marinum. Clin Dermatol 1995;13:273-276. https://doi.org/10.1016/0738-081X(95)00023-9
  7. Petrini B. Mycobacterium marinum: ubiquitous agent of waterborne granulomatous skin infections. Eur J Clin Microbiol Infect Dis 2006;25:609-613. https://doi.org/10.1007/s10096-006-0201-4
  8. Pang HN, Lee JY, Puhaindran ME, Tan SH, Tan AB, Yong FC. Mycobacterium marinum as a cause of chronic granulomatous tenosynovitis in the hand. J Infect 2007;54:584-588. https://doi.org/10.1016/j.jinf.2006.11.014