1/43. Atypical mycobacterium infection with dermatological manifestation in a renal transplant recipient.In April 1997, a 58-year-old renal transplant recipient presented with abscess-like nodules in his left calf and on his right foot. Furuncular disease was suspected and the patient was treated with flucloxacillin. However, the lesions increased in size and became ulcerative. In the following 3 months, cultures of punctuated material, blood, and urine remained negative and gram stains did not reveal micro-organisms. In June 1997, acid-fast stains were positive. A diagnosis of a nontuberculous mycobacterium (NTM) infection was made and empirical antimycobacterial therapy was started. The combination of relatively minor symptoms with enlarged purulent lesions, causing severe morbidity, raises the possibility of NTM infection in the immunocompromised patient.- - - - - - - - - - ranking = 1keywords = mycobacterium, ulcer (Clic here for more details about this article) |
2/43. mycobacterium ulcerans infection (buruli ulcer): first reported case in a traveler.A chronic, painless sore developed over a 2-month period on the left calf of a Canadian man traveling for 8 months in africa. A presumptive diagnosis of a Mycobacterium spp. infection was made despite initially negative biopsy and culture results, after failure of several courses of anti-bacterial antibiotics. mycobacterium ulcerans was eventually isolated and the lesion progressed despite treatment with multiple anti-mycobacterial agents. The lesion finally responded to wide and repeated excision, aggressive treatment with anti-mycobacterial antibiotics, and split-thickness skin grafting. The isolation and treatment of this unusual organism are discussed.- - - - - - - - - - ranking = 8.657801165981keywords = ulcerans infection, ulcerans, ulcer (Clic here for more details about this article) |
3/43. Subcutaneous abscesses in a patient with ulcerative colitis.Ulcerative colitis (UC) is a clinical form of inflammatory bowel disease. The association of pyoderma gangrenosum or erythema nodosum with UC is well known. In addition, pustular eruption has been reported in UC. We describe a patient with UC who exhibited subcutaneous abscesses, as well as pustular eruption with a clinical course paralleling that of UC exacerbation.- - - - - - - - - - ranking = 0.000534927569111keywords = ulcer (Clic here for more details about this article) |
4/43. Familial cluster of cutaneous mycobacterium avium infection resulting from use of a circulating, constantly heated bath water system.We describe familial cases of cutaneous infection caused by mycobacterium avium. A 45-year-old father, his 14-year-old son and 11-year-old daughter, among five persons in a family, presented with a 2-month history of inflammatory subcutaneous nodules and ulcerations. histology of skin biopsy specimens showed granulomatous inflammation, and mycobacterial colonies isolated from the skin of each patient were identified as M. avium by dna hybridization analysis. The patients were all treated successfully with combined drug therapy consisting of rifampicin, isoniazid and clarithromycin. Their lesions were purely cutaneous M. avium infection, without any visceral involvement. Neither systemic disease nor immunological impairment was detected in the family. However, they all used a circulating, constantly heated bath water system. The bath water was continuously heated to about 40 degrees C without changing the water for a few months, and M. avium was isolated from the filter of the bath tub heating unit. It is considered that this unusual familial cluster of cutaneous M. avium infection in healthy persons may have resulted from the use of contaminated bath water.- - - - - - - - - - ranking = 0.00013373189227775keywords = ulcer (Clic here for more details about this article) |
5/43. Cutaneous mycobacterium chelonae in a liver transplant patient.A 51-year-old woman with an orthotopic liver transplant on tacrolimus (SKF 506) and prednisone presented with an erythematous ulcerated nodule on the knee. No preceding trauma was noted. A skin biopsy specimen demonstrated beaded gram-positive, acid-fast rods and the skin culture grew mycobacterium chelonae (formerly M chelonae subsp chelonae ). This report describes the first case in a liver transplant patient of cutaneous mycobacterium chelonae under the current method of designating atypical Mycobacterium species.- - - - - - - - - - ranking = 0.00013373189227775keywords = ulcer (Clic here for more details about this article) |
6/43. Cutaneous infection due to mycobacterium kansasii.A patient presented with chronic leg ulcers after a mowing accident. He received several courses of antibiotics for presumed cellulitis, underwent surgical debridement, and was treated empirically with cyclosporin for presumed pyoderma gangrenosum, all without improvement. Cultures from prior debridement revealed mycobacterium kansasii, and he was successfully treated with triple antituberculous regimen. Cutaneous infections due to this slow growing Mycobacterium are rare and may resemble cellulitis or sporotrichosis. mycobacterium kansasii should be included in the differential diagnosis of skin infections with an indolent course and lack of response to antibiotics.- - - - - - - - - - ranking = 0.00013373189227775keywords = ulcer (Clic here for more details about this article) |
7/43. mycobacterium ulcerans infection (buruli ulcer): a case report of the disseminated nonulcerative form.The world health organization recognizes mycobacterium ulcerans infection (buruli ulcer) as a reemerging disease. Classically, lesions are indolent, undermined ulcers of the skin. The characteristic histopathologic changes are provoked by a soluble toxin of M ulcerans that is necrotizing and immunosuppressive. After tuberculosis and leprosy, buruli ulcer is the third most common mycobacterial disease in humans. We report buruli ulcer in a patient in benin, West africa, with widespread edema and diffuse induration of approximately one half of the skin of the trunk. There was no ulceration. The tissue studied was a 16-cm portion excised from the center of the large surgical specimen. Histopathologic analysis showed massive contiguous necrosis of the dermis and subcutis in sections of biopsy specimens from the center, at 2-cm intervals in two radii from the center to the periphery, and at 5-cm intervals around the margin. Acid-fast bacilli infiltrated all specimens except at one peripheral site. Samples of the entire surgical specimen taken from seven sites before fixation were polymerase chain reaction and culture positive for M ulcerans. The disseminated nonulcerative form of M ulcerans infection is well known, but is now increasingly frequent in some highly endemic areas, especially in West africa. This patient died within 48 hours postsurgery, but cause of death was not established. The only regularly effective treatment for advanced lesions is surgical excision of all infected tissue. Estimation of the lateral limits of invasion by M ulcerans may help the surgeon establish the optimal extent of excision. Refinement of the basic concept we used and adaptation to preoperative assessment of the limit of bacterial invasion are urgently needed, especially for massive lesions.- - - - - - - - - - ranking = 13.831956410946keywords = ulcerans infection, ulcerans, ulcer (Clic here for more details about this article) |
8/43. Nasal tip ulceration from infection and extrusion of a nasal alloplastic implant.Nasal augmentation rhinoplasty is a common cosmetic procedure. Alloplastic or synthetic materials are frequently used with Silastic, the most commonly used type worldwide. In the Orient, this common procedure has a low complication rate. However, infection and extrusion of the implant through the skin may occur and patients may be reluctant to report the augmentation procedure to the dermatologist. Therefore, the dermatologist needs to be highly suspicious and include this complication in the differential of ulcerated nasal tip nodules.- - - - - - - - - - ranking = 0.00066865946138875keywords = ulcer (Clic here for more details about this article) |
9/43. Isolation and polymerase chain reaction typing of borrelia afzelii from a skin lesion in a seronegative patient with generalized ulcerating bullous lichen sclerosus et atrophicus.A 64-year-old woman presented with bullous and ulcerating lichen sclerosus et atrophicus (LSA) on the neck, trunk, genital and perigenital area and the extremities. histology of lesional skin showed the typical manifestations of LSA; in one of the biopsies spirochaetes were detected by silver staining. Despite treatment with four courses of ceftriaxone with or without methylprednisone for up to 20 days, progression of LSA was only stopped for a maximum of 1 year. Spirochaetes were isolated from skin cultures obtained from enlarging LSA lesions. These spirochaetes were identified as borrelia afzelii by sodium dodecyl sulphate--polyacrylamide gel electrophoresis and polymerase chain reaction (PCR) analyses. However, serology for B. burgdorferi sensu lato was repeatedly negative. After one further 28-day course of ceftriaxone the lesions stopped expanding and sclerosis of the skin was diminished. At this time cultures for spirochaetes and PCR of lesional skin for B. afzelii dna remained negative. These findings suggest a pathogenetic role for B. afzelii in the development of LSA and a beneficial effect of appropriate antibiotic treatment.- - - - - - - - - - ranking = 0.00066865946138875keywords = ulcer (Clic here for more details about this article) |
10/43. infection of the skin caused by corynebacterium ulcerans and mimicking classical cutaneous diphtheria.Extrapharyngeal infections caused by corynebacterium ulcerans have rarely been reported previously, and diphtheria toxin production has usually not been addressed. This case demonstrates that strains of C. ulcerans that produce diphtheria toxin can cause infections of the skin that completely mimic typical cutaneous diphtheria, thereby potentially providing a source of bacteria capable of causing life-threatening diseases in the patient's environment. Therefore, it is recommended to screen wound swabs for coryneform bacteria, identify all isolates, carefully assess possible toxin production, and send questionable strains to a specialist or a reference laboratory.- - - - - - - - - - ranking = 3.3767392273465keywords = ulcerans, ulcer (Clic here for more details about this article) |
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