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Hautinfektionen durch atypische Mykobakterien

Cutaneous infections due to atypyical mycobacteria

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Zusammenfassung

Atypische Mykobakterien sind Umweltsaphrophyten. Hautverletzungen können die Eintrittspforte für lokalisierte Hautinfekte sein. Klinisch finden sich entzündliche Knoten, Plaques, Ulzera oder pannikulitisartige Läsionen. Disseminierte Hautinfekte treten vorwiegend bei Immunsupprimierten auf. Der Nachweis atypischer Mykobakterien erfolgt über eine Gewebeprobe. Wichtig ist der kulturelle Nachweis, der häufig nur bei geäußertem klinischem Verdacht gelingt, weil das Anzüchten einiger atypischer Mykobakterien spezielle Nährböden und Anzüchttemperaturen erfordert. Das Buruli-Ulkus, durch M. ulcerans verursacht, ist die weltweit häufigste atypische Mykobakteriose und tritt in tropischen Regionen auf. In Europa ist das Schwimmbadgranulom, verursacht durch M. marinum, häufig. M.-avium-Komplex, M. kansasii und schnell wachsende Mykobakterien des M.-fortuitum-Komplexes sind weitere Verursacher kutaner Mykobakteriosen. Die Therapie ist schwierig, weil viele Keime resistent gegen gängige Antituberkulotika und Antibiotika sind.

Abstract

Atypical mycobacteria are environmental saprophytes. Occasionally they may enter human skin through injuries and cause localized infection. Papules, nodules, plaques, ulcers and panniculitis-like lesions are common manifestations. Disseminated infection occurs in immunocompromised patients. Evidence of mycobacterial infection can be obtained by tissue specimens, culture being most important for diagnosis. Because many mycobacteria only grow on special media and at special temperatures it is crucial that clinical suspicion is raised so correct testing is performed. Buruli ulcer caused by M. ulcerans is the most prevalent atypical mycobacteriosis worldwide; its occurrence is restricted to tropical areas. In European countries fish tank granuloma caused by M. marinum is most commonly observed. M. avium-complex, M. kansasii und rapidly growing mycobacteria of M. fortuitum-complex are other atypical mycobacteria that can cause cutaneous infection. Treatment is difficult because many atypical mycobacteria are resistant to common antibiotics.

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Authors and Affiliations

  1. Dermatologische Abteilung, Kantonsspital Aarau, Tellstrasse, 5001, Aarau, Schweiz

    M. Streit

  2. Infektiologie, Kantonsspital Aarau, Aarau, Schweiz

    T. Bregenzer

  3. Hygienisch-mikrobiologisches Institut, Kantonsspital Aarau, Aarau, Schweiz

    I. Heinzer

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  1. M. Streit
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  2. T. Bregenzer
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  3. I. Heinzer
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Correspondence to M. Streit.

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Streit, M., Bregenzer, T. & Heinzer, I. Hautinfektionen durch atypische Mykobakterien. Hautarzt 59, 59–71 (2008). https://doi.org/10.1007/s00105-007-1447-1

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  • DOI: https://doi.org/10.1007/s00105-007-1447-1

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