Mycobacterium fortuitum

Introduction

Non pigmented (non chromagen).

Epidemiology

• causes HIV-associated mycobacterial infection

Pathology

• disseminated multiorgan disease
• cutaneous lesions
  • immunosuppressed patients
    • generally after trauma, surgery, catheterization, cosmetic procedures
  • Mycobacterium fortuitum furunculosis occurs in patients who obtain pedicures at nail salons that use contaminated whirlpool footbaths
  • skin biopsy: necrotizing granulomatous dermatitis

Clinical manifestations

• erythematous nodules & paplules
• furuculosis & ulceration

Laboratory

• rapidly growing in culture
  • cultures generally positive within 1 week vs 2-6 weeks
    • case report of positive culture in 4 days
• also see Mycobacterium

Management

• not susceptible to standard anti-tuberculosis drugs
• most strains are susceptible to clarithromycin & amikacin
• other potentially useful agents include: Bactrim, fluoroquinolones, tetracyclines, imipenem, cefoxitin
• minimum of 4 months of therapy

More general terms

• Mycobacterium