Skip to main content

Advertisement

SpringerLink
Log in

Mycobacterial Skin and Soft Tissue Infection

  • Skin, Soft Tissue, Bone and Joint Infectious Diseases (N Safdar, Section Editor)
  • Published:
Current Infectious Disease Reports Aims and scope Submit manuscript

Abstract

Mycobacterial skin and soft tissue infection (SSTI) includes nontuberculous mycobacterial (NTM) infections, tuberculosis (TB), and leprosy. Diagnosis of mycobacterial SSTI can be challenging due to diverse clinical presentation, low yield from cultured specimens, and nonspecific histopathology on tissue biopsy. In addition, immunosuppressed patients may present with atypical or disseminated disease. Despite aggressive medical treatment and often with surgical intervention, results may be suboptimal with poor outcomes. Regimens typically require multiple antibiotics for extended periods of time and are often complicated by medication side effects and drug-drug interactions. Biopsy with culture is the gold standard for diagnosis, but newer molecular diagnostics and proteomics such as matrix-assisted laser desorption ionization-time of flight mass spectrometry have improved diagnosis with increased identification of clinically significant mycobacteria species in clinically relevant time frames. We will review updates in diagnostic tests along with clinical presentation and treatment of mycobacterial SSTI for NTM, TB, and leprosy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Euzeby JP. List of prokaryotic names with stranding in nomenclature-genus Mycobacterium. Edited by Parte A.C. http://www.bacterio.net. Accessed 10 Jun 2014.

  2. Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F, et al. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med. 2007;175:367–416.

    Article  PubMed  CAS  Google Scholar 

  3. Brown-Elliott BA, Wallace JR. Rapidly growing mycobacteria. In: Schlossberg D, editor. Tuberculosis and nontuberculous mycobacterial infections. 6th ed. Washington: ASM; 2011. p. 565–77.

    Google Scholar 

  4. Hill MK, Sanders CV. Cutaneous tuberculosis. In: Schlossberg D, editor. Tuberculosis and nontuberculosis mycobacterial infections. 6th ed. Washington: ASM Press; 2011. p. 409–14.

    Google Scholar 

  5. World Health Organization. Leprosy today. http://www.who.int/lep/en/. Accessed 10 Jun 2014.

  6. Winthrop KL, Iseman M. Bedfellows: mycobacteria and rheumatoid arthritis in the era of biologic therapy. Nat Rev Rheumatol. 2013;9:524–31.

    Article  PubMed  Google Scholar 

  7. Salvana EM, Cooper GS, Salata RA. Mycobacterium other than tuberculosis (MOTT) infection: an emerging disease in infliximab-treated patients. J Infect. 2007;55:484–7.

    Article  PubMed  Google Scholar 

  8. Balada-Llasat JM, Kamboj K, Pancholi P. Identification of mycobacteria from solid and liquid media by matrix-assisted laser desorption ionization-time of flight mass spectrometry in the clinical laboratory. J Clin Microbiol. 2013;51:2875–9. Clinical use of MALDI-TOF for mycobacteria identification at a large academic center.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  9. Esteban J, Garcia-Pedrazuela M, Munoz-Egea MC, Alcaide F. Current treatment of nontuberculous mycobacteriosis: an update. Expert Opin Pharmacother. 2012;13:967–86. An updated review of NTM treatment.

    Article  PubMed  CAS  Google Scholar 

  10. Patel T, Scroggins-Markle L, Kelly B. A dermal piercing complicated by Mycobacterium fortuitum. Case Rep Dermatol Med. 2013;2013:149829.

    PubMed  PubMed Central  Google Scholar 

  11. Quinones C, Ramalle-Gomara E, Perucha M, Lezaun ME, Fernandez-Vilarino E, Garcia-Morras P, et al. An outbreak of Mycobacterium fortuitum cutaneous infection associated with mesotherapy. J Eur Acad Dermatol Venereol. 2010;24:604–6.

    Article  PubMed  CAS  Google Scholar 

  12. Guevara-Patino A, de Sandoval MM, Farreras A, Rivera-Olivero I, Fermin D, de Waard JH. Soft tissue infection due to Mycobacterium fortuitum following acupuncture: a case report and review of the literature. J Infect Dev Ctries. 2010;4:521–5.

    PubMed  Google Scholar 

  13. Schnabel D, Gaines J, Nguyen DB, Esposito DH, Ridpath A, Yacisin K, et al. Notes from the field: rapidly growing nontuberculous Mycobacterium wound infections among medical tourists undergoing cosmetic surgeries in the Dominican Republic—multiple states, March 2013–February 2014. MMWR Morb Mortal Wkly Rep. 2014;63:201–2.

    PubMed  Google Scholar 

  14. Galmes-Truyols A, Gimenez-Duran J, Bosch-Isabel C, Nicolau-Riutort A, Vanrell-Berga J, Portell-Arbona M, et al. An outbreak of cutaneous infection due to Mycobacterium abscessus associated to mesotherapy. Enferm Infecc Microbiol Clin. 2011;29:510–4.

    Article  PubMed  Google Scholar 

  15. Stout JE, Gadkowski LB, Rath S, Alspaugh JA, Miller MB, Cox GM. Pedicure-associated rapidly growing mycobacterial infection: an endemic disease. Clin Infect Dis. 2011;53:787–92.

    Article  PubMed  Google Scholar 

  16. Ivan M, Dancer C, Koehler AP, Hobby M, Lease C. Mycobacterium chelonae abscesses associated with biomesotherapy, Australia, 2008. Emerg Infect Dis. 2008;19:1493–5.

    Google Scholar 

  17. Kennedy BS, Bedard B, Younge M, Tuttle D, Ammerman E, Ricci J, et al. Outbreak of Mycobacterium chelonae infection associated with tattoo ink. N Engl J Med. 2012;367:1020–4.

    Article  PubMed  CAS  Google Scholar 

  18. Marcoval J, Alcaide F. Evolution of cutaneous tuberculosis over the past 30 years in a tertiary hospital on the European Mediterranean coast. Clin Exp Dermatol. 2013;38:131–6. Good review of cutaneous TB cases from 1981 to 2011 at a European Medical Center.

    Article  PubMed  CAS  Google Scholar 

  19. Feng Y, Xu H, Wang H, Zhang C, Zong W, Wu Q. Outbreak of a cutaneous Mycobacterium marinum infection in Jiangsu Haian, China. Diagn Microbiol Infect Dis. 2011;71:267–72.

    Article  PubMed  Google Scholar 

  20. Giulieri S, Morisod B, Edney T, Odman M, Genne D, Malinverni R, et al. Outbreak of Mycobacterium haemophilum infections after permanent makeup of the eyebrows. Clin Infect Dis. 2011;52:488–91.

    Article  PubMed  Google Scholar 

  21. Tortoli E, Pecorari M, Fabio G, Messino M, Fabio A. Commercial DNA probes for mycobacteria incorrectly identify a number of less frequently encountered species. J Clin Microbiol. 2010;48:307–10.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  22. Bryant JM, Grogono DM, Greaves D, Foweraker J, Roddick I, Inns T, et al. Whole-genome sequencing to identify transmission of Mycobacterium abscessus between patients with cystic fibrosis: a retrospective cohort study. Lancet. 2013;381:1551–60.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  23. Piersimoni C. Nontuberculous mycobacteria infection in solid organ transplant recipients. Eur J Clin Microbiol Infect Dis. 2012;31:397–403. Good review of NTM in transplant patients.

    Article  PubMed  CAS  Google Scholar 

  24. Atkins BL, Gottlieb T. Skin and soft tissue infections caused by nontuberculous mycobacteria. Curr Opin Infect Dis. 2014;27:137–45. Current review of NTM skin and soft tissue infections.

    Article  PubMed  CAS  Google Scholar 

  25. Wentworth AB, Drage LA, Wengenack NL, Wilson JW, Lohse CM. Increased incidence of cutaneous nontuberculous mycobacterial infection, 1980 to 2009: a population-based study. Mayo Clin Proc. 2013;88:38–45.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Wallace Jr RJ, Brown BA, Griffith DE. Nosocomial outbreaks/pseudo-outbreaks caused by nontuberculous mycobacteria. Annu Rev Microbiol. 1998;52:453–90.

    Article  PubMed  CAS  Google Scholar 

  27. Winthrop KL, Abrams M, Yakrus M, Schwartz I, Ely J, Gillies D, et al. An outbreak of mycobacterial furunculosis associated with footbaths at a nail salon. N Engl J Med. 2002;346:1366–71.

    Article  PubMed  Google Scholar 

  28. Conaglen PD, Laurenson IF, Sergeant A, Thorn SN, Rayner A, Stevenson J. Systematic review of tattoo-associated skin infection with rapidly growing mycobacteria and public health investigation of a cluster in Scotland, 2010. Eur Surveill. 2013;18:20553. Literature review of recent tattoo associated NTM infections.

    CAS  Google Scholar 

  29. Furuya EY, Paez A, Srinivasan A, Cooksey R, Augenbraun M, Baron M, et al. Outbreak of Mycobacterium abscessus wound infections among “lipotourists” from the United States who underwent abdominoplasty in the Dominican Republic. Clin Infect Dis. 2008;46:1181–8.

    Article  PubMed  Google Scholar 

  30. Meyers H, Brown-Elliott BA, Moore D, Curry J, Truong C, Zhang Y, et al. An outbreak of Mycobacterium chelonae infection following liposuction. Clin Infect Dis. 2002;34:1500–7.

    Article  PubMed  Google Scholar 

  31. Thomas M, D’Silva JA, Borole AJ, Chilgar RM. Periprosthetic atypical mycobacterial infection in breast implants: a new kid on the block! J Plast Reconstr Aesthet Surg. 2013;66:e16–9.

    Article  PubMed  Google Scholar 

  32. Duarte RS, Lourenco MC, Fonseca LS, Leao SC, Amorim EL, Rocha IL, et al. Epidemic of postsurgical infections caused by Mycobacterium massiliense. J Clin Microbiol. 2009;47:2149–55.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Rogall T, Flohr T, Bottger EC. Differentiation of Mycobacterium species by direct sequencing of amplified DNA. J Gen Microbiol. 1990;136:1915–20.

    Article  PubMed  CAS  Google Scholar 

  34. Slany M, Pavlik I. Molecular detection of nontuberculous mycobacteria: advantages and limits of a broad-range sequencing approach. J Mol Microbiol Biotechnol. 2012;22:268–76.

    Article  PubMed  CAS  Google Scholar 

  35. Sansila A, Hongmanee P, Chuchottaworn C, Rienthong S, Rienthong D, Palittapongarnpim P. Differentiation between Mycobacterium tuberculosis and Mycobacterium avium by amplification of the 16S-23S ribosomal DNA spacer. J Clin Microbiol. 1998;36:2399–403.

    PubMed  CAS  PubMed Central  Google Scholar 

  36. McNerney R, Maeurer M, Abubakar I, Marais B, McHugh TD, Ford N, et al. Tuberculosis diagnostics and biomarkers: needs, challenges, recent advances, and opportunities. J Infect Dis. 2012;205 Suppl 2:S147–58.

    Article  PubMed  Google Scholar 

  37. Richardson ET, Samson D, Banaei N. Rapid identification of Mycobacterium tuberculosis and nontuberculous mycobacteria by multiplex, real-time PCR. J Clin Microbiol. 2009;47:1497–502.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  38. Butler WR, Guthertz LS. Mycolic acid analysis by high-performance liquid chromatography for identification of Mycobacterium species. Clin Microbiol Rev. 2001;14:704–26. table.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  39. Saleeb PG, Drake SK, Murray PR, Zelazny AM. Identification of mycobacteria in solid-culture media by matrix-assisted laser desorption ionization-time of flight mass spectrometry. J Clin Microbiol. 2011;49:1790–4.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Lotz A, Ferroni A, Beretti JL, Dauphin B, Carbonnelle E, Guet-Revillet H, et al. Rapid identification of mycobacterial whole cells in solid and liquid culture media by matrix-assisted laser desorption ionization-time of flight mass spectrometry. J Clin Microbiol. 2010;48:4481–6.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  41. Woods GL, Brown-Elliott BA. Susceptibility testing of mycobacteria, nocardia, and other aerobic actinomycetes, approved standards. CLSI document M24-A1. 2011. Wayne, PA, Clinical and Laboratory Standard Institute. Ref Type: Pamphlet.

  42. Bastian S, Veziris N, Roux AL, Brossier F, Gaillard JL, Jarlier V, et al. Assessment of clarithromycin susceptibility in strains belonging to the Mycobacterium abscessus group by erm(41) and rrl sequencing. Antimicrob Agents Chemother. 2011;55:775–81.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  43. Leao SC, Tortoli E, Euzeby JP, Garcia MJ. Proposal that Mycobacterium massiliense and Mycobacterium bolletii be united and reclassified as Mycobacterium abscessus subsp. bolletii comb. nov., designation of Mycobacterium abscessus subsp. abscessus subsp. nov. and emended description of Mycobacterium abscessus. Int J Syst Evol Microbiol. 2011;61:2311–3.

    Article  PubMed  Google Scholar 

  44. Koh WJ, Jeon K, Lee NY, Kim BJ, Kook YH, Lee SH, et al. Clinical significance of differentiation of Mycobacterium massiliense from Mycobacterium abscessus. Am J Respir Crit Care Med. 2011;183:405–10.

    Article  PubMed  Google Scholar 

  45. Broutin V, Banuls AL, Aubry A, Keck N, Choisy M, Bernardet JF, et al. Genetic diversity and population structure of Mycobacterium marinum: new insights into host and environmental specificities. J Clin Microbiol. 2012;50:3627–34.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Lalvani A, Nagvenkar P, Udwadia Z, Pathan AA, Wilkinson KA, Shastri JS, et al. Enumeration of T cells specific for RD1-encoded antigens suggests a high prevalence of latent Mycobacterium tuberculosis infection in healthy urban Indians. J Infect Dis. 2001;183:469–77.

    Article  PubMed  CAS  Google Scholar 

  47. Harboe M, Oettinger T, Wiker HG, Rosenkrands I, Andersen P. Evidence for occurrence of the ESAT-6 protein in Mycobacterium tuberculosis and virulent Mycobacterium bovis and for its absence in Mycobacterium bovis BCG. Infect Immun. 1996;64:16–22.

    PubMed  CAS  PubMed Central  Google Scholar 

  48. Berthet FX, Rasmussen PB, Rosenkrands I, Andersen P, Gicquel B. A Mycobacterium tuberculosis operon encoding ESAT-6 and a novel low-molecular-mass culture filtrate protein (CFP-10). Microbiology. 1998;144(Pt 11):3195–203.

    Article  PubMed  CAS  Google Scholar 

  49. Kuznetcova TI, Sauty A, Herbort CP. Uveitis with occult choroiditis due to Mycobacterium kansasii: limitations of interferon-gamma release assay (IGRA) tests (case report and mini-review on ocular non-tuberculous mycobacteria and IGRA cross-reactivity). Int Ophthalmol. 2012;32:499–506.

    Article  PubMed  Google Scholar 

  50. Wu TS, Chiu CH, Yang CH, Leu HS, Huang CT, Chen YC, et al. Fish tank granuloma caused by Mycobacterium marinum. PLoS One. 2012;7:e41296.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  51. Parrish N, Luethke R, Dionne K, Carroll K, Riedel S. Case of Mycobacterium marinum infection with unusual patterns of susceptibility to commonly used antibiotics. J Clin Microbiol. 2011;49:2056–8.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Dolenc-Voljc M, Zolnir-Dovc M. Delayed diagnosis of Mycobacterium marinum infection: a case report and review of the literature. Acta Dermatovenerol Alp Pannonica Adriat. 2010;19:35–9.

    PubMed  Google Scholar 

  53. Brown BA, Wallace Jr RJ, Onyi GO. Activities of clarithromycin against eight slowly growing species of nontuberculous mycobacteria, determined by using a broth microdilution MIC system. Antimicrob Agents Chemother. 1992;36:1987–90.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  54. Merritt RW, Walker ED, Small PL, Wallace JR, Johnson PD, Benbow ME, et al. Ecology and transmission of Buruli ulcer disease: a systematic review. PLoS Negl Trop Dis. 2010;4:e911. Good review of Buruli ulcer.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Trubiano JA, Lavender CJ, Fyfe JA, Bittmann S, Johnson PD. The incubation period of Buruli ulcer (Mycobacterium ulcerans infection). PLoS Negl Trop Dis. 2013;7:e2463.

    Article  PubMed  PubMed Central  Google Scholar 

  56. World Health Organization. Treatment of Mycobacterium ulcerans disease (Buruli ulcer). 2014. http://apps.who.int/iris/bitstream/10665/77771/1/9789241503402_eng.pdf. Accessed 10 Jun 2014.

  57. O’Brien DP, Robson M, Friedman ND, Walton A, McDonald A, Callan P, et al. Incidence, clinical spectrum, diagnostic features, treatment and predictors of paradoxical reactions during antibiotic treatment of Mycobacterium ulcerans infections. BMC Infect Dis. 2013;13:416.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Nienhuis WA, Stienstra Y, Abass KM, Tuah W, Thompson WA, Awuah PC, et al. Paradoxical responses after start of antimicrobial treatment in Mycobacterium ulcerans infection. Clin Infect Dis. 2012;54:519–26.

    Article  PubMed  Google Scholar 

  59. Yeboah-Manu D, Kpeli GS, Ruf MT, Asan-Ampah K, Quenin-Fosu K, Owusu-Mireku E, et al. Secondary bacterial infections of buruli ulcer lesions before and after chemotherapy with streptomycin and rifampicin. PLoS Negl Trop Dis. 2013;7:e2191.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  60. Lindeboom JA, Bruijnesteijn van Coppenraet LE, van Soolingen D, Prins JM, Kuijper EJ. Clinical manifestations, diagnosis, and treatment of Mycobacterium haemophilum infections. Clin Microbiol Rev. 2011;24:701–17. Good review of clinical manifestation, diagnosis, and treatment for M. haemophilum.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Shah MK, Sebti A, Kiehn TE, Massarella SA, Sepkowitz KA. Mycobacterium haemophilum in immunocompromised patients. Clin Infect Dis. 2001;33:330–7.

    Article  PubMed  CAS  Google Scholar 

  62. Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America. Clin Infect Dis. 2014. Updated practice guidelines for management of skin and soft tissue infectious from Infectious Disease Society of America. Good overall review of SSTI, has section on cellular immunity defects and non-tuberculous mycobacteria infections.

  63. Saubolle MA, Kiehn TE, White MH, Rudinsky MF, Armstrong D. Mycobacterium haemophilum: microbiology and expanding clinical and geographic spectra of disease in humans. Clin Microbiol Rev. 1996;9:435–47.

    PubMed  CAS  PubMed Central  Google Scholar 

  64. Sompolinsky D, Lagziel A, Rosenberg I. Further studies of a new pathogenic mycobacterium (M. haemophilum sp. nov.). Can J Microbiol. 1979;25:217–26.

    Article  PubMed  CAS  Google Scholar 

  65. Dawson DJ, Jennis F. Mycobacteria with a growth requirement for ferric ammonium citrate, identified as Mycobacterium haemophilum. J Clin Microbiol. 1980;11:190–2.

    PubMed  CAS  PubMed Central  Google Scholar 

  66. Ducharlet K, Murphy C, Tan SJ, Dwyer KM, Goodman D, Aboltins C, et al. Recurrent Mycobacterium haemophilum in a renal transplant recipient. Nephrology (Carlton). 2014;19 Suppl 1:14–7.

    Article  Google Scholar 

  67. World Health Organization. Tuberculosis. 2014. http://www.who.int/mediacentre/factsheets/fs104/en/. Accessed 10 Jun 2014.

  68. Centers fro Disease Control and Prevention. Reported tuberculosis in the United States, 2012. 2013. http://www.cdc.gov/tb/statistics/reports/2012/pdf/report2012.pdf. Accessed 10 Jun 2014.

  69. Handog EB, Gabriel TG, Pineda RT. Management of cutaneous tuberculosis. Dermatol Ther. 2008;21:154–61.

    Article  PubMed  Google Scholar 

  70. Beyt Jr BE, Ortbals DW, Santa Cruz DJ, Kobayashi GS, Eisen AZ, Medoff G. Cutaneous mycobacteriosis: analysis of 34 cases with a new classification of the disease. Medicine (Baltimore). 1981;60:95–109.

    Article  Google Scholar 

  71. Burgin S, Pomeranz MK, Obruch P, Shupack J, Brand RS. Mycobacteria and the skin. In: Rom W, Garay SM, Bloom BR, editors. Tuberculosis. 2nd ed. Toronto: Little, Brown and Company; 2004. p. 593–608.

    Google Scholar 

  72. Wong HW, Tay YK, Sim CS. Papular eruption on a tattoo: a case of primary inoculation tuberculosis. Australas J Dermatol. 2005;46:84–7.

    Article  PubMed  Google Scholar 

  73. Horney DA, Gaither JM, Lauer R, Norins AL, Mathur PN. Cutaneous inoculation tuberculosis secondary to ‘jailhouse tattooing’. Arch Dermatol. 1985;121:648–50.

    Article  PubMed  CAS  Google Scholar 

  74. Ghorpade A. Lupus vulgaris over a tattoo mark—inoculation tuberculosis. J Eur Acad Dermatol Venereol. 2003;17:569–71.

    Article  PubMed  CAS  Google Scholar 

  75. Jensen PA, Lambert LA, Iademarco MF, Ridzon R. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005. MMWR Recomm Rep. 2005;54:1–141.

    PubMed  Google Scholar 

  76. Hutton MD, Stead WW, Cauthen GM, Bloch AB, Ewing WM. Nosocomial transmission of tuberculosis associated with a draining abscess. J Infect Dis. 1990;161:286–95.

    Article  PubMed  CAS  Google Scholar 

  77. Woods GL, Bergmann JS, Williams-Bouyer N. Clinical evaluation of the Gen-Probe amplified mycobacterium tuberculosis direct test for rapid detection of Mycobacterium tuberculosis in select nonrespiratory specimens. J Clin Microbiol. 2001;39:747–9.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  78. O’Sullivan CE, Miller DR, Schneider PS, Roberts GD. Evaluation of Gen-Probe amplified mycobacterium tuberculosis direct test by using respiratory and nonrespiratory specimens in a tertiary care center laboratory. J Clin Microbiol. 2002;40:1723–7.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Lalvani A. Diagnosing tuberculosis infection in the 21st century: new tools to tackle an old enemy. Chest. 2007;131:1898–906.

    Article  PubMed  Google Scholar 

  80. Lalvani A, Pareek M. Interferon gamma release assays: principles and practice. Enferm Infecc Microbiol Clin. 2010;28:245–52.

    Article  PubMed  Google Scholar 

  81. American Thoracic Society, CDC, Infectious Diseases Society of America. Treatment of tuberculosis. MMWR Recomm Rep. 2003;52:1–77.

    Google Scholar 

  82. Curry International Tuberculosis Center and California Department of Public Health. Drug-resistant tuberculosis, a survival guide for clinicians, 2011. [2nd edition]. 2011. http://www.currytbcenter.ucsf.edu/products/product_details.cfm?productID=WPT-11. Accessed 10 Jun 2014.

  83. Centers fro Disease Control and Prevention. Report of expert consultations on rapid molecular testing to detect drug-resistant tuberculosis in the United States. 2013. http://www.cdc.gov/tb/topic/laboratory/rapidmoleculartesting/default.htm. Accessed 10 Jun 2014.

  84. Truman RW, Singh P, Sharma R, Busso P, Rougemont J, Paniz-Mondolfi A, et al. Probable zoonotic leprosy in the southern United States. N Engl J Med. 2011;364:1626–33. Identification of a possible link between leprosy cases in the US and armadillo.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

Download references

Acknowledgments

The authors would like to acknowledge Dr. William Maher for assistance with the editing of the manuscript and to all contributors of the photos.

Compliance with Ethics Guidelines

ᅟ

Conflict of Interest

Shu-Hua Wang and Preeti Pancholi have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the author.

Author information

Authors and Affiliations

  1. Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University Wexner Medical Center, N-1120 Doan Hall, Columbus, OH, 43210, USA

    Shu-Hua Wang

  2. Clinical Microbiology, Department of Pathology, The Ohio State University Wexner Medical Center, 1492 E Broad Street, Columbus, OH, 43205, USA

    Preeti Pancholi

Authors
  1. Shu-Hua Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Preeti Pancholi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shu-Hua Wang.

Additional information

This article is part of the Topical Collection on Skin, Soft Tissue, Bone and Joint Infectious Diseases

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, SH., Pancholi, P. Mycobacterial Skin and Soft Tissue Infection. Curr Infect Dis Rep 16, 438 (2014). https://doi.org/10.1007/s11908-014-0438-5

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11908-014-0438-5

Keywords

Search

Navigation