Background: Nontuberculous mycobacterial (NTM) disease is commonly an opportunistic infection frequently\nfound in immunocompromised individuals, but sometimes can also be found in the immunocompetent hosts,\nespecially in East Asians. The NTM separation rate in China is increasing, which reminds us to focus on NTM\ninfections in immunocompromised populations.\nCase presentation: A 43-year-old woman with a recurrent fever for more than 8-month and a right forehead\nsurgical wounds unhealed for more than 6-month was admitted to our hospital on February 22, 2018. On arrival,\nseveral elliptic ulcers were obvious on the right forehead with pus and fibrin exudation, and the skin around the\nlesions was tender, reddish, no sense of fluctuation. The result of HIV serology test was negative. CD4+ T cell count\nwas normal and tuberculosis antibody was negative. CT of the chest and head showed bone destruction. Skin\nbiopsy on the right forehead was performed on March 13, 2018, and pathological examination of the excisional\nbiopsy specimen found inflammatory granuloma and suppurative inflammatory changes. Broad-spectrum\nantibiotics were treated but the effect seemed discontent. Then debridement and skin grafting were performed on\nthe right frontal ulcer under general anesthesia on April 3, 2018. The skin tissue culture that resected on March 13,\n2018 found Nontuberculous mycobacteria grown after 78 days, so clarithromycin, ethambutol, protionamide, and\namoxicillin clavulanate potassium were prescribed for anti-nontuberculous mycobacteria treatment beginning on\nMay 31, 2018. In reviewing the case, Mycobacterium avium (M. avium) was identified in the skin tissue resected on\nApril 3, 2018 by polymerase chain reaction (PCR) and the serum test of anti-interferon-Yautoantibodies was\npositive.\nConclusions: This is a case report of â??Mycobacterium avium SSTI (skin and soft tissue infection) and OM\n(osteomyelitis) with possible secondary immunodeficiency syndrome induced by anti-interferon- Y autoantibodyâ?.
Loading....