RESUMO
Mycobacterium chelonae frequently involves the skin, and the disseminated form can be observed in immunocompromised patients. In contrast, rhinosinusitis caused by the bacterium is a rare manifestation, which occurs independently of immune status. We report here a rare case of M. chelonae infection presenting as both disseminated cutaneous infection and rhinosinusitis in an immunocompromised patient. He had received systemic corticosteroids for 11 months due to cryptogenic organizing pneumonia. Before admission, he sustained injuries to his left arm and hand; those injuries succumbed to an infection that would subsequently spread to his other limbs, face, and even nasal cavities. This valuable case suggests that disseminated cutaneous infection by M. chelonae could spread to other organs.
Assuntos
Sinusite Maxilar/microbiologia , Infecções por Mycobacterium não Tuberculosas/complicações , Mycobacterium chelonae , Rinite/microbiologia , Dermatopatias Bacterianas/microbiologia , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Evolução Fatal , Humanos , Hospedeiro Imunocomprometido , Masculino , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológicoRESUMO
IMPORTANCE: USA300 is an MRSA clone producing PVL, a toxin associated with SSTIs. ΨUSA300 is a USA300 variant recently identified in Japan by Takadama et al. (15). Here, we found that the prevalence rate of PVL-positive MRSA in S. aureus was elevated in the Japanese community, and ΨUSA300 accounted for most of them. ΨUSA300 strains have been isolated from several areas in Japan and were associated with deep-seated SSTIs. This study highlighted the emerging threat posed by ΨUSA300 in Japan.