PMID- 37151046
OWN - NLM
STAT- MEDLINE
DCOM- 20230609
LR  - 20230622
IS  - 2374-4243 (Electronic)
IS  - 2374-4243 (Linking)
VI  - 55
IP  - 7
DP  - 2023 Jul
TI  - Clinical manifestations, treatment and outcomes of patients infected with 
      Mycobacterium haemophilum with a focus on immune reconstitution inflammatory 
      syndrome: a retrospective multi-site study.
PG  - 467-479
LID - 10.1080/23744235.2023.2208210 [doi]
AB  - BACKGROUND: Mycobacterium haemophilum is a nontuberculous mycobacterium with 
      fastidious in vitro growth requirements and an increasingly reported cause of 
      extrapulmonary disease. Timely diagnosis and management of M. haemophilum 
      infections and the immune reconstitution inflammatory syndromes (IRIS) observed 
      in a subset of patients during treatment remain challenging. METHODS: We 
      conducted a retrospective chart review between January 1, 2010, and January 1, 
      2022 and identified 26 patients diagnosed with M. haemophilum infection at our 
      institution. We describe their clinical presentation, diagnostic results, 
      management, and outcomes. RESULTS: The majority of patients in our cohort had 
      upper and/or lower extremity skin involvement, were immunosuppressed, and had 
      generally favourable treatment outcomes. All tested M. haemophilum isolates were 
      susceptible in vitro to clarithromycin and trimethoprim-sulfamethoxazole. 
      Moreover, high rates of susceptibility were noted for ciprofloxacin (95%), 
      linezolid (90%), and rifampin (85%). IRIS was identified in 31% of cases and 
      should be considered in patients who develop worsening skin lesions or systemic 
      symptoms following the initiation of effective antimicrobial therapy. 
      Visualisation of acid-fast bacilli on initial tissue stains, a positive 
      mycobacterial blood culture, and rapid de-escalation of tumour necrosis factor-alpha 
      inhibitors and/or corticosteroids were more frequently encountered among patients 
      in our cohort who developed IRIS. CONCLUSION: M. haemophilum infection should be 
      considered among patients receiving immunomodulatory therapy who develop 
      discoloured or nodular skin lesions involving the extremities, worsening focal 
      arthritis, tenosynovitis, or isolated adenopathy. A heightened awareness of this 
      pathogen's clinical and laboratory characteristics can lead to a timely diagnosis 
      and favourable outcome.
FAU - El Zein, Said
AU  - El Zein S
AD  - Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, 
      MN, USA.
FAU - Abu Saleh, Omar M
AU  - Abu Saleh OM
AD  - Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, 
      MN, USA.
FAU - Wengenack, Nancy L
AU  - Wengenack NL
AD  - Division of Clinical Microbiology, Department of Laboratory Medicine and 
      Pathology, Mayo Clinic, Rochester, MN, USA.
FAU - Wilson, John W
AU  - Wilson JW
AD  - Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, 
      MN, USA.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20230507
PL  - England
TA  - Infect Dis (Lond)
JT  - Infectious diseases (London, England)
JID - 101650235
SB  - IM
MH  - Humans
MH  - *Immune Reconstitution Inflammatory Syndrome/drug therapy/microbiology
MH  - *Mycobacterium haemophilum
MH  - *Mycobacterium Infections/drug therapy
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Mycobacterium haemophilum
OT  - immune reconstitution inflammatory syndrome
OT  - iris
OT  - treatment
EDAT- 2023/05/08 06:42
MHDA- 2023/06/09 06:42
CRDT- 2023/05/08 03:40
PHST- 2023/06/09 06:42 [medline]
PHST- 2023/05/08 06:42 [pubmed]
PHST- 2023/05/08 03:40 [entrez]
AID - 10.1080/23744235.2023.2208210 [doi]
PST - ppublish
SO  - Infect Dis (Lond). 2023 Jul;55(7):467-479. doi: 10.1080/23744235.2023.2208210. 
      Epub 2023 May 7.