RESUMO
INTRODUCTION: Dermatologic manifestations of diseases in solid organ transplant recipients are common due to long-term immunosuppression. CASE PRESENTATION: We present the case of a 63-year-old man with a kidney transplant who exhibited subcutaneous nodules on lower extremities, cytopenia, and asymptomatic pulmonary infiltrate. Through a skin biopsy and 16S ribosomal RNA (rRNA) sequencing, Mycobacterium haemophilum was identified. His clinical course was complicated by empyema, septic arthritis, and recurrence of his skin manifestations, despite ongoing antimicrobial treatment. DISCUSSION: This case emphasizes the challenges and potential complications associated with M haemophilum infections in solid organ transplant recipients receiving long-term immunosuppressive therapy. It highlights the importance of employing advanced diagnostic techniques when evaluating dermatologic manifestations in these patients. The patient's complex clinical course also underscores the difficulties involved in effectively addressing and managing complications that may arise even after initiating therapy.
Assuntos
Transplante de Rim , Mycobacterium haemophilum , Humanos , Transplante de Rim/efeitos adversos , Masculino , Pessoa de Meia-Idade , Mycobacterium haemophilum/isolamento & purificação , Infecções por Mycobacterium/diagnóstico , Infecções por Mycobacterium/microbiologia , Infecções por Mycobacterium/tratamento farmacológico , Hospedeiro ImunocomprometidoAssuntos
Doença de Crohn/complicações , Infecções por Mycobacterium/diagnóstico , Mycobacterium haemophilum/isolamento & purificação , Dermatopatias Bacterianas/diagnóstico , Idoso , Feminino , Humanos , Hospedeiro Imunocomprometido , Infecções por Mycobacterium/microbiologia , Infecções por Mycobacterium/patologia , Dermatopatias Bacterianas/microbiologia , Dermatopatias Bacterianas/patologiaRESUMO
BACKGROUND: Nontuberculous mycobacteria (NTM) lymphadenitis is an under-recognized entity, and data of the true burden in children are limited. Without a high index of suspicion, diagnosis may be delayed and microbiological detection is challenging. Here, we report a cluster of NTM lymphadenitis experienced in Korean children. METHODS: Subjects under 19 years of age diagnosed with NTM lymphadenitis during November 2016-April 2017 and April 2018 were included. Electronic medical records were reviewed for clinical, laboratory and pathological findings. Information regarding underlying health conditions and environmental exposure factors was obtained through interview and questionnaires. RESULTS: A total of ten subjects were diagnosed during 18 months. All subjects were 8-15 years of age, previously healthy, male and had unilateral, nontender, cervicofacial lymphadenitis for more than 3 weeks with no significant systemic symptoms and no response to empirical antibiotics. Lymph nodes involved were submandibular (n = 8), preauricular (n = 6) and submental (n = 1). Five patients had two infected nodes and violaceous discoloration was seen in seven subjects. Biopsy specimens revealed chronic granulomatous inflammation and acid-fast bacteria culture identified Mycobacterium haemophilum in two cases and NTM polymerase chain reaction was positive in two cases. Survey revealed various common exposure sources. CONCLUSION: NTM lymphadenitis is rare but increasing in detection and it may occur in children and adolescents. Diagnosis requires high index of suspicion and communication between clinicians and the laboratory is essential for identification of NTM.
Assuntos
Linfadenite/diagnóstico , Infecções por Mycobacterium não Tuberculosas/patologia , Adolescente , Antibacterianos/uso terapêutico , Criança , Humanos , Linfadenite/tratamento farmacológico , Linfadenite/etiologia , Masculino , Infecções por Mycobacterium não Tuberculosas/complicações , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Mycobacterium haemophilum/genética , Mycobacterium haemophilum/isolamento & purificação , Micobactérias não Tuberculosas/genética , Micobactérias não Tuberculosas/isolamento & purificação , RNA Bacteriano/metabolismoAssuntos
Antibacterianos/administração & dosagem , Hospedeiro Imunocomprometido , Leucemia Mieloide Aguda/imunologia , Infecções por Mycobacterium/tratamento farmacológico , Mycobacterium haemophilum/isolamento & purificação , Dermatopatias Bacterianas/tratamento farmacológico , Antibacterianos/uso terapêutico , Humanos , Leucemia Mieloide Aguda/terapia , Masculino , Pessoa de Meia-Idade , Mycobacterium haemophilum/patogenicidade , Transplante de Células-Tronco/efeitos adversosAssuntos
Infecções por Mycobacterium/diagnóstico , Mycobacterium haemophilum/isolamento & purificação , Dermatopatias Bacterianas/diagnóstico , Síndrome de Sweet/diagnóstico , Adulto , Biópsia , Diagnóstico Diferencial , Feminino , Rejeição de Enxerto/imunologia , Rejeição de Enxerto/prevenção & controle , Humanos , Hospedeiro Imunocomprometido , Terapia de Imunossupressão/efeitos adversos , Transplante de Rim/efeitos adversos , Infecções por Mycobacterium/imunologia , Infecções por Mycobacterium/microbiologia , Pele/patologia , Dermatopatias Bacterianas/imunologia , Dermatopatias Bacterianas/microbiologiaAssuntos
Transplante de Coração , Hospedeiro Imunocomprometido , Imunossupressores/efeitos adversos , Infecções por Mycobacterium/diagnóstico , Mycobacterium haemophilum/isolamento & purificação , Osteomielite/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Adolescente , Feminino , Humanos , Infecções por Mycobacterium/imunologia , Osteomielite/imunologia , Complicações Pós-Operatórias/imunologiaRESUMO
Nontuberculous mycobacterial infections can often occur in individuals with adequate immune function. Such infections typically have cutaneous involvement and are caused by rapidly growing mycobacterium. Other nontuberculous mycobacteria species, like Mycobacterium haemophilum, almost always present as opportunistic infections occurring in severely immunocompromised hosts. Here, we present a complicated and protracted course of diagnosing M. haemophilum lower extremity cutaneous infection in a matched-unrelated donor stem cell transplant recipient.
Assuntos
Antibacterianos/uso terapêutico , Celulite (Flegmão)/tratamento farmacológico , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Leucemia Mieloide Aguda/cirurgia , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Mycobacterium haemophilum/isolamento & purificação , Infecções Oportunistas/tratamento farmacológico , Biópsia , Celulite (Flegmão)/complicações , Celulite (Flegmão)/diagnóstico , Celulite (Flegmão)/microbiologia , Ciprofloxacina/uso terapêutico , Claritromicina/uso terapêutico , Feminino , Doença Enxerto-Hospedeiro/diagnóstico , Doença Enxerto-Hospedeiro/tratamento farmacológico , Humanos , Hospedeiro Imunocomprometido , Terapia de Imunossupressão/efeitos adversos , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Extremidade Inferior , Pessoa de Meia-Idade , Infecções por Mycobacterium não Tuberculosas/complicações , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções por Mycobacterium não Tuberculosas/microbiologia , Infecções Oportunistas/complicações , Infecções Oportunistas/diagnóstico , Infecções Oportunistas/microbiologia , Rifabutina/uso terapêutico , Tacrolimo/efeitos adversos , Tacrolimo/uso terapêutico , Doadores não RelacionadosRESUMO
Opportunistic infections are a major concern in renal and transplant medicine. We present the case of a renal transplant recipient with a generalised Mycobacterium haemophilum infection after an increase in immunosuppressive therapy and treatment with a tumour necrosis factor-α (TNF-α) inhibitor. Infection involved skin and soft tissue, joints and bones, as well as the renal transplant with an interstitial nephritis. Rapid diagnosis using PCR and DNA sequencing allowed early appropriate treatment. Triple antibiotic therapy and reduction in immunosuppression resulted in a slow but sustained recovery. Immunosuppression causes severe opportunistic infections. TNF-α inhibitors are very effective and well tolerated but have an increased susceptibility to infections with mycobacteria. Mycobacterial infections represent a significant clinical risk to transplant recipients because of their aggressive clinical course and the need for complex toxic antibiotic treatments. In these patients, M. haemophilum is a cause of skin infections.
Assuntos
Hospedeiro Imunocomprometido , Transplante de Rim , Infecções por Mycobacterium/diagnóstico , Infecções por Mycobacterium/imunologia , Mycobacterium haemophilum/isolamento & purificação , Infecções Oportunistas/diagnóstico , Infecções Oportunistas/imunologia , Adulto , Antituberculosos/uso terapêutico , Biópsia , Humanos , Imunossupressores/uso terapêutico , Testes de Função Renal , Masculino , Infecções por Mycobacterium/tratamento farmacológico , Infecções Oportunistas/tratamento farmacológicoRESUMO
Mycobacteriosis is infrequently reported in free-ranging sea turtles. Nontuberculous Mycobacterium haemophilum was identified as the causative agent of disseminated mycobacteriosis in a juvenile leatherback turtle (Dermochelys coriacea) that was found stranded on the Atlantic coast of Florida. Disseminated granulomatous inflammation was identified histologically, most notably affecting the nervous system. Identification of mycobacterial infection was based on cytologic, molecular, histologic, and microbiologic methods. Among stranded sea turtles received for diagnostic evaluation from the Atlantic and Gulf of Mexico coasts of the United States between 2004 and 2015, the diagnosis of mycobacteriosis was overrepresented in stranded oceanic-phase juveniles compared with larger size classes, which suggests potential differences in susceptibility or exposure among different life phases in this region. We describe M. haemophilum in a sea turtle, which contributes to the knowledge of diseases of small juvenile sea turtles, an especially cryptic life phase of the leatherback turtle.
Assuntos
Infecções por Mycobacterium/veterinária , Mycobacterium haemophilum/isolamento & purificação , Tartarugas , Animais , Diagnóstico Diferencial , Florida , Infecções por Mycobacterium/diagnósticoRESUMO
Mycobacterium haemophilum is a slow-growing non-tuberculous mycobacterium that is rarely known to cause human skin infection, particularly in immunocompromised patients. We recently experienced a 69-year-old Japanese woman with this infection who had been under immunosuppressive treatment for recalcitrant rheumatoid arthritis. The patient showed disseminated erythematous plaques and subcutaneous nodules on the face and extremities, and interestingly, the face manifested with a striking "facies leontina" appearance. Biopsy revealed abscess and granulomatous dermatitis with the involvement of peripheral nerve bundles and the presence of innumerable acid-fast bacilli, thus necessitating differentiation from lepromatous leprosy. M. haemophilum was identified by molecular characterization as well as by successful culture with iron supplements. Although drug susceptibility testing indicated responsiveness to multiple antibiotics administrated simultaneously for the treatment, it took over 6 months to achieve significant improvement, and we also employed concurrent oral potassium iodide administration and repeated surgical excision. This case highlights the importance of continuous combination therapy for successful outcome in this rare infection. Furthermore, application of potassium iodide for mycobacterial infection warrants further evaluation by accumulating more cases.
Assuntos
Hanseníase/diagnóstico , Infecções por Mycobacterium/diagnóstico , Mycobacterium haemophilum/isolamento & purificação , Idoso , Diagnóstico Diferencial , Face/patologia , Feminino , Humanos , Infecções por Mycobacterium/patologia , Infecções por Mycobacterium/terapiaRESUMO
We report a case of disseminated Mycobacterium haemophilum osteomyelitis in a patient with advanced HIV infection, who later developed recurrent immune reconstitution inflammatory syndrome after commencement of antiretroviral therapy. We review previous reports of M. haemophilum bone and joint infection associated with HIV infection and describe the management of M. haemophilum-associated immune reconstitution inflammatory syndrome, including the role of surgery as an adjunctive treatment modality and the potential drug interactions between antiretroviral and antimycobacterial agents.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Infecções por HIV/complicações , Síndrome Inflamatória da Reconstituição Imune/complicações , Infecções por Mycobacterium/diagnóstico , Mycobacterium haemophilum/isolamento & purificação , Osteomielite/microbiologia , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Adulto , Articulação do Tornozelo , Antibacterianos/uso terapêutico , Fármacos Anti-HIV/uso terapêutico , Desbridamento , Infecções por HIV/tratamento farmacológico , Humanos , Síndrome Inflamatória da Reconstituição Imune/microbiologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium/tratamento farmacológico , Infecções por Mycobacterium/microbiologia , Mycobacterium haemophilum/genética , Osteomielite/diagnóstico , Osteomielite/terapia , Reação em Cadeia da Polimerase , Tenossinovite/microbiologia , Tenossinovite/cirurgiaRESUMO
Mycobacterium haemophilum is an environmental organism that rarely causes infections in humans. We report a patient with acquired immunodeficiency syndrome who had central nervous system infection due to M. haemophilum. The diagnosis required brain tissue procurement and molecular identification method while the treatment outcome was unfavourable.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Síndrome da Imunodeficiência Adquirida/complicações , Infecções do Sistema Nervoso Central/microbiologia , Infecções por Mycobacterium não Tuberculosas/microbiologia , Mycobacterium haemophilum/isolamento & purificação , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Adulto , Antibacterianos/uso terapêutico , Biópsia , Infecções do Sistema Nervoso Central/diagnóstico , Infecções do Sistema Nervoso Central/tratamento farmacológico , Evolução Fatal , Feminino , Humanos , Dados de Sequência Molecular , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Infecções por Mycobacterium não Tuberculosas/patologia , Mycobacterium haemophilum/genética , RNA Bacteriano/análise , RNA Ribossômico 16S/análise , TailândiaRESUMO
A sub-adult male Assam trinket snake (Elaphe frenata) that was confiscated from an exotic animal dealer was found dead in its enclosure after a 17-mo quarantine. The snake had grown well during that period and had no physical examination or bloodwork abnormalities during the quarantine. On gross necropsy, masses were found in the epaxial musculature and stomach, the lung was diffusely thickened, the ventricular wall was mottled, and there was intracoelomic and pericardial effusion. Histopathology revealed diffusely disseminated granulomatous infiltrates throughout the lung interstitium and multifocal granulomatous infiltrates in the transmural gastric mass, within the myocardium and pericardial adipose tissue, in the liver and kidney parenchyma, in the cervical region surrounding the trachea and thyroid, and replacing the myofibers of the craniolateral epaxial muscles. Fite-Farracho acid-fast staining revealed numerous intracytoplasmic acid-fast bacilli within macrophages, and polymerase chain reaction testing on frozen tissues followed by nucleic acid sequencing of polymerase chain reaction amplicons identified Mycobacterium haemophilum.
Assuntos
Infecções por Mycobacterium/veterinária , Mycobacterium haemophilum/isolamento & purificação , Serpentes , Animais , Evolução Fatal , Masculino , Infecções por Mycobacterium/microbiologia , Infecções por Mycobacterium/patologiaRESUMO
PURPOSE: To compare surgical excision with surgical curettage in the treatment of nontuberculous mycobacterial (NMT) cervicofacial lymphadenitis in children. PATIENTS AND METHODS: Fifty children, 22 boys and 28 girls, with a PCR- or cultured-confirmed diagnosis of cervicofacial NTM infection were included in the study. Twenty-five children were randomized to surgical excision of the involved lymph nodes, and 25 children to surgical curettage. RESULTS: The median age of the children was 36 months (range, 14-120 months). All children had a red, fluctuating lymphadenitis, and there were no marked differences between the treatment groups with respect to mean duration of lymph node swelling before presentation, location, and the size of the lymph node swelling. Most (84%) of the involved nodes were located in the submandibular region and 6% were located in the preauricular region. Multiple locations (both preauricular and submandibular) were observed in the remaining 10%. Mycobacterium avium (74%) and Mycobacterium haemophilum (22%) were the predominant NTM species. Mean wound healing time for the excision group was 3.6 ± 1.2 weeks versus 11.4 ± 5.1 weeks for the curettage group (P ≤ .05). Postoperative transient marginal mandibular nerve weakness of the facial nerve was seen in 4 patients (16%) of the excision group. In all these patients the function of the nerve returned to normal within 12 weeks. No facial nerve problems were observed in the curettage group. Postoperative infections were not observed. CONCLUSIONS: Surgical excision leads to a quick resolution of NTM cervicofacial lymphadenitis. Curettage leads to delayed healing but might be considered as an alternative if excision of the necrotized lymph nodes is technically difficult in cases of adherence of the facial nerve branche.
Assuntos
Curetagem/métodos , Excisão de Linfonodo/métodos , Linfadenite/cirurgia , Infecções por Mycobacterium não Tuberculosas/cirurgia , Criança , Pré-Escolar , Traumatismos do Nervo Facial/etiologia , Feminino , Seguimentos , Humanos , Lactente , Linfadenite/microbiologia , Masculino , Nervo Mandibular/fisiopatologia , Infecções por Mycobacterium/cirurgia , Complexo Mycobacterium avium/isolamento & purificação , Infecção por Mycobacterium avium-intracellulare/cirurgia , Mycobacterium haemophilum/isolamento & purificação , Esvaziamento Cervical/métodos , Complicações Pós-Operatórias , Estudos Prospectivos , Recuperação de Função Fisiológica/fisiologia , Fatores de Tempo , Resultado do Tratamento , Traumatismos do Nervo Trigêmeo/etiologia , Cicatrização/fisiologiaRESUMO
We present here the first report of disseminated skin Mycobacterium infections in two liver transplant recipients, in which hsp65 gene sequencing was used for rapid species identification. Both patients had hepatitis B virus-related cirrhosis and diabetes mellitus and presented with progressive generalized, nodular skin lesions. In one patient, a 50-year-old woman who had frequent contact with marine fish, an acid-fast bacillus was isolated from skin biopsy tissue after 2 months of culture. While awaiting phenotypic identification results, hsp65 gene sequencing showed that it was most closely related to that of Mycobacterium marinum with 100% nucleotide identity. The patient was treated with oral rifampin, ethambutol, and moxifloxacin. In the other patient, a 59-year-old woman, direct PCR for Mycobacterium using hsp65 gene from skin biopsy tissue was positive, with the sequence most closely related to that of M. haemophilum with 100% nucleotide identity. Based on PCR results, the patient was treated with clarithromycin, ethambutol, moxifloxacin, and amikacin. A strain of M. haemophilum was only isolated after 3 months. Skin lesions of both patients resolved after 1 year of antimycobacterial therapy. Nontuberculous Mycobacterium infections should be considered in liver transplant recipients presenting with chronic, nodular skin lesions. This report highlights the crucial role of hsp65 gene PCR and sequencing on both cultured isolates and direct clinical specimens for rapid diagnosis of slow-growing Mycobacterium infection.
Assuntos
Transplante de Fígado , Infecções por Mycobacterium/diagnóstico , Mycobacterium haemophilum/isolamento & purificação , Mycobacterium marinum/isolamento & purificação , Dermatopatias Bacterianas/diagnóstico , Transplante , Antibacterianos/administração & dosagem , Proteínas de Bactérias/genética , Chaperonina 60/genética , Feminino , Humanos , Hospedeiro Imunocomprometido , Pessoa de Meia-Idade , Dados de Sequência Molecular , Infecções por Mycobacterium/tratamento farmacológico , Infecções por Mycobacterium/microbiologia , Infecções por Mycobacterium/patologia , Mycobacterium haemophilum/genética , Mycobacterium marinum/genética , Análise de Sequência de DNA , Dermatopatias Bacterianas/microbiologia , Dermatopatias Bacterianas/patologiaRESUMO
We report the case of a 22-year-old man who presented with a Mycobacterium haemophilum and Histoplasma capsulatum coinfection occurring 21 years after a living-donor-related renal transplant.
Assuntos
Histoplasma/isolamento & purificação , Histoplasmose/complicações , Histoplasmose/diagnóstico , Infecções por Mycobacterium/complicações , Infecções por Mycobacterium/diagnóstico , Mycobacterium haemophilum/isolamento & purificação , Biópsia , Histocitoquímica , Histoplasmose/microbiologia , Humanos , Transplante de Rim/efeitos adversos , Masculino , Microscopia , Infecções por Mycobacterium/microbiologia , Pele/patologia , Transplante , Adulto JovemRESUMO
BACKGROUND: The prevalence of infections by nontuberculous mycobacteria (NTM) has steadily increased over the past decades, especially in immunocompromised patients. CASE PRESENTATION: We present a patient with IgA-deficiency and mixed cutaneous infection by two slowly growing mycobacteria, Mycobacterium (M.) haemophilum and M. kansasii. CONCLUSIONS: Cutaneous M. haemophilum infections most often result from HIV or transplantation-associated immunosuppression. Rarely, M. haemophilum may also infect healthy patients or iatrogenically immunosuppressed patients without transplantation. M. kansasii is one of the most frequent NTM and large awareness exists about its involvement in human diseases. Mycobacterial diagnosis of cutaneous infections should be considered in long-lasting skin lesions.
Assuntos
Deficiência de IgA/complicações , Infecções por Mycobacterium não Tuberculosas/complicações , Infecções por Mycobacterium/complicações , Mycobacterium haemophilum/isolamento & purificação , Mycobacterium kansasii/isolamento & purificação , Dermatopatias Bacterianas/complicações , Antibacterianos/uso terapêutico , Biópsia , Claritromicina/administração & dosagem , Claritromicina/uso terapêutico , Quimioterapia Combinada , Etambutol/administração & dosagem , Etambutol/uso terapêutico , Humanos , Hospedeiro Imunocomprometido , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium/imunologia , Infecções por Mycobacterium/microbiologia , Infecções por Mycobacterium/patologia , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Infecções por Mycobacterium não Tuberculosas/imunologia , Infecções por Mycobacterium não Tuberculosas/microbiologia , Infecções por Mycobacterium não Tuberculosas/patologia , Mycobacterium haemophilum/crescimento & desenvolvimento , Mycobacterium kansasii/crescimento & desenvolvimento , Rifabutina/administração & dosagem , Rifabutina/uso terapêutico , Dermatopatias Bacterianas/tratamento farmacológico , Dermatopatias Bacterianas/imunologia , Dermatopatias Bacterianas/microbiologia , Dermatopatias Bacterianas/patologiaRESUMO
We report a Mycobacterium haemophilum outbreak after permanent make-up of the eyebrows performed by the same freelance artist. Twelve patients presented an eyebrow lesion and cervical lymphadenitis. All were treated with antibiotics. Surgery was required in 10 cases. M. haemophilum DNA was identified in the make-up ink.
Assuntos
Surtos de Doenças , Sobrancelhas/microbiologia , Infecções por Mycobacterium/diagnóstico , Infecções por Mycobacterium/epidemiologia , Mycobacterium haemophilum/isolamento & purificação , Tatuagem/efeitos adversos , Tuberculose dos Linfonodos/diagnóstico , Sobrancelhas/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Infecções por Mycobacterium/microbiologia , Infecções por Mycobacterium/patologia , Tuberculose dos Linfonodos/complicaçõesRESUMO
A 52-year-old male with a history of renal transplantation and chronic iatrogenic immunosuppression presented with a several-week history of hyperpigmented cutaneous nodules on bilateral upper and lower extremities. Biopsy showed inflammatory granulomatous dermatitis caused by acid-fast bacilli (AFB). However, tissue cultures for mycobacterium were repeatedly negative. The patient was diagnosed with Mycobacterium haemophilum based on PCR results and was placed on empiric antibiotic therapy.
Assuntos
Transplante de Rim/efeitos adversos , Mycobacterium haemophilum/isolamento & purificação , Tuberculose Cutânea/diagnóstico , Antibacterianos/uso terapêutico , Fármacos Dermatológicos/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Mycobacterium haemophilum/efeitos dos fármacos , Resultado do Tratamento , Tuberculose Cutânea/tratamento farmacológico , Tuberculose Cutânea/microbiologia , Tuberculose Cutânea/patologiaRESUMO
We describe a case and summarize six additional cases of cervical lymphadenitis in otherwise healthy adults caused by Mycobacterium haemophilum. The organism causes cervicofacial lymphadenitis in healthy children and severe disease in immunocompromised patients but has not been previously reported to cause cervical lymphadenitis in nonimmunocompromised, healthy adults.