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Co‐infection of S cedosporium apiospermum and M ycobacterium chelonae in an immunocompetent host
Author(s) -
Kim Ji Seok,
Choi Misoo,
Nam Chan Hee,
Kim Jee Young,
Hong Seung Phil,
Kim Myung Hwa,
Park Byung Cheol
Publication year - 2014
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/1346-8138.12601
Subject(s) - mycobacterium chelonae , scedosporium apiospermum , medicine , gram staining , clarithromycin , forearm , biopsy , pathology , biology , antibiotics , dermatology , microbiology and biotechnology , antifungal , tuberculosis , mycobacterium , voriconazole
A 75‐year‐old man presented with multiple, scaly, erythematous, grouped papules, nodules and plaques with tenderness ranging from the right forearm to hand dorsum and the right lower leg for 2–3 months. Five months prior to presentation, the patient had received an antibiotic skin test on his right forearm. Lesions appeared approximately 2–3 months after the antibiotic skin test, slowly progressing without clinical improvement. Culture for fungus on the right forearm revealed growth of S cedosporium apiospermum . The tissue acid‐fast bacilli ( AFB ) culture for the right forearm and right leg revealed growth of non‐tuberculous mycobacteria which was M ycobacterium chelonae , and subsequent tissue polymerase chain reaction of both sites reported positive signs of M . chelonae . On diastase periodic acid‐ S chiff stain of the biopsy specimen of the right forearm, fungal hyphae were found while rod‐shaped bacilli could be seen in AFB stain for the biopsy specimen of the right leg. The patient was treated with oral clarithromycin and ciprofloxacin along with an oral antifungal agent for 13 weeks. After the treatment, the lesions subsided and left a scar. We report a rare case of co‐infection of S . apiospermum and M . chelonae in an immunocompetent host.