[Mycobacterium fortuitum infection caused by the organism in subcutaneous abscess mediated by central venous catheter].

A 49-year-old woman with a Mycobacterium fortuitum bloodstream infection, who has been managed with central venous (CV) catheterization for two years, was reported. She had undergone rectectomy for rectal cancer and gastectomy for stomach cancer at the ages of 36 and 42, respectively. Also, she had undergone adhesiotomy for four times for postoperative ileus at the ages between 44 and 47. She was admitted to our hospital because of fever (38.4 degrees C) with chill and fatigue, and a subcutaneous abscess at the right infraclavicular region located at the insertion site of the CV catheter (Hickman catheter). After the catheter was removed, the subcutaneous abscess was incised and a Penrose drain tube was inserted. M. fortuitum was detected after three days of blood culture and on the blood agar medium inoculated with purulent discharge from the drainage tube. After receiving these treatments, she was discharged from the hospital one month later. The isolates from these blood and purulent discharge specimens were identical on pulsed-field gel electrophoresis. Based on these findings, we concluded that the M. fortuitum bloodstream infection in this case might be caused by the organism in the subcutaneous abscess mediated by the CV catheter.

Overexpression of serpin squamous cell carcinoma antigens in psoriatic skin.

Squamous cell carcinoma antigen belongs to the serpin family and is used for the diagnosis and management of squamous cell carcinoma. We investigated the involvement of squamous cell carcinoma antigen in psoriasis, as it is always detected in the sera of patients with psoriasis. Squamous cell carcinoma antigen localization in psoriatic epidermis varied depending on its concentration in the patient's sera. When its level was low in serum, weak and scattered staining was observed in the granular layer. With a high concentration of squamous cell carcinoma antigen, strong staining through the suprabasal to granular layer and condensed staining around the plasma membrane or intracellular space was detected in the affected epidermis. Interestingly, squamous cell carcinoma antigen was abundant in nuclei of the granular layer cells and elongated rete ridges. Immunoelectron microscopy confirmed the localization of squamous cell carcinoma antigen in the nuclei as well as in the periphery of the cell membrane. A cDNA library was constructed from psoriatic epidermis and both clones, SCCA1 and SCCA2, were obtained. Attempts to raise specific antibodies or to prepare cRNA probes for SCCA1 and SCCA2 were unsuccessful because of their nearly identical structures. A primer pair from each reactive site sequence enabled us to give a distinctive product for SCCA1 and SCCA2 by reverse transcription polymerase chain reaction. Analysis using these primers demonstrated that the SCCA2 transcript was specifically expressed in psoriatic skin tissues. Our results suggest that overexpression of squamous cell carcinoma antigens is associated with the disease activity of psoriasis.