A Case of Disseminated Mycobacterium Haemophilum in a Kidney Transplant Recipient Presenting With Subcutaneous Nodules.

Xi Ran Li, Devesh Kumar, Amber Y Bo, Jenna T Le, Ariana Ellis, Kara Young, Karolyn A Wanat, Mohan Dhariwal, Pinky Jha, Jaime Green, Sol Aldrete
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Abstract

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.

一例表现为皮下结节的肾移植受者体内播散的嗜血分枝杆菌病例
导言:由于长期免疫抑制,皮肤病在实体器官移植受者中很常见:本病例是一名 63 岁的肾移植患者,下肢皮下结节、全血细胞减少和无症状肺部浸润。通过皮肤活检和 16S 核糖体 RNA(rRNA)测序,确定了嗜血分枝杆菌。尽管他一直在接受抗菌治疗,但他的临床病程因肺水肿、化脓性关节炎和皮肤症状复发而变得复杂:本病例强调了长期接受免疫抑制治疗的实体器官移植受者感染嗜血杆菌所带来的挑战和潜在并发症。它强调了在评估这些患者的皮肤表现时采用先进诊断技术的重要性。患者复杂的临床病程也凸显了有效处理和控制并发症所涉及的困难,这些并发症甚至可能在开始治疗后出现。
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