Mycobacterium abscessus Infection in Dermatomyositis with Calcinosis Cutis Universalis
Article Sidebar
Main Article Content
Abstract
Dermatomyositis (DM) is a rare autoimmune condition that may be complicated by calcinosis cutis, particularly in juvenile forms. In adults, extensive calcinosis is uncommon and once it ulcerates, it may lead to recurrent infections. Mycobacterium Abscessus is a rapidly growing nontuberculous mycobacterium (NTM) very rarely associated with DM, especially in disseminated infections. We report the case of a 28-year-old female with amyopathic DM and calcinosis cutis universalis who developed disseminated M. abscessus infection. The patient presented with cutaneous and pulmonary involvement, and M. abscessus was isolated from both skin fistulas and pleural effusion, demanding long-term antibiotic therapy. This is the fourth reported case of Mycobacterium Abscessus infection in a patient with dermatomyositis (DM), and the first linked to calcinosis cutis. This case underscores the importance of considering atypical mycobacterial infections in immunosuppressed patients with connective tissue diseases, especially when faced with recurrent or unusual infections. Furthermore, it highlights how skin barrier disruption caused by calcinosis may predispose immunocompromised individuals to such atypical infections.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Jiang W, Yang H, Li S, Tian X, Wang G. Clinical features, treatments and outcomes of calcinosis in adult patients with der-matomyositis: a single cohort study. Rheumatology (Oxford). 2021;60(6):2958–62.
Gutierrez A Jr, Wetter DA. Calcinosis cutis in autoimmune connective tissue diseases. Dermatol Ther. 2012;25(2):195–206.
Davuluri S, Duvvuri B, Lood C, Faghihi-Kashani S, Chung L. Calcinosis in dermatomyositis: Origins and possible therapeu-tic avenues. Best Pract Res Clin Rheumatol. 2022;36(2):101768.
Marie I, Hachulla E, Chérin P, Hellot MF, Herson S, Levesque H, et al. Opportunistic infections in polymyositis and derma-tomyositis. Arthritis Rheum. 2005;53(2):155–65.
Haldule S, Chatterjee M, Goswami RP, Vadsaria I, Gaur P, Kavadichanda C, et al. A systematic review and meta-analysis of mycobacterial infections in patients with idiopathic inflammatory myopathies. Rheumatology. 2022;61(9):3521–33.
Huang YC, Liu MF, Shen GH, Lin CF, Kao CC, Liu PY, et al. Clinical outcome of Mycobacterium Abscessus infection and anti-microbial susceptibility testing. J Microbiol Immunol Infect. 2010;43(5):401–6.
Fukui S, Sekiya N, Takizawa Y, Morioka H, Kato H, Aono A, et al. Disseminated Mycobacterium Abscessus infection follo-wing septic arthritis. Medicine (Baltimore). 2015;94(21):e861.
Stout JE, Gadkowski LB, Rath S, Alspaugh JA, Miller MA, Cox GW. Pedicure-associated rapidly growing mycobacterial infection: an endemic disease. Clin Infect Dis. 2011;53(8):787–92.
Gonzales Zamora JA, Villar Astete A. Mycobacterium Abscessus felon complicated with osteomyelitis: not an ordinary nail salon visit. Acta Clin Belg. 2020;75(6):429–33.
Costa-Silva M, César A, Nuno PG, Azavedo F. Mycobacterium Abscessus infection in a spa worker. Acta Dermatovenerol Alp Pannonica Adriat. 2018;27(3):159–60.
Kim J, Kim YJ, Park H, Lee S, Yoo DH. Nontuberculous mycobacterial myositis in dermatomyositis with long-term use of immunosuppressant: a case report. Skeletal Radiol. 2024;53(10):2289–96.
Noguchi S, Hanami K, Miyata H, Torii R, Shimabukuro I, Kubo S, et al. Pleurisy caused by Mycobacterium Abscessus in a young patient with dermatomyositis: a case report and brief review of the literature. Intern Med. 2018;57(7):997–1002.
Spellberg B, Yoo T, Bayer AS. Reversal of linezolid-associated cytopenias, but not peripheral neuropathy, by administration of vitamin B6. J Antimicrob Chemother. 2004;54(4):832–5.