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Description:
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This well-illustrated book is a comprehensive guide to the cutaneous clinical presentations of mycobacterial infections. The Mycobacterium genus includes over 170 species, nontuberculous mycobacteria (NTM) having been added to the obligate human pathogens such as M. tuberculosis and M. leprae. NTM are widely distributed in the environment with high isolation rates worldwide; the skin is a major target with variable clinical manifestations. A current ?resurgence in tuberculosis is aggravated by the synergy with human immunodeficiency virus, the breakdown of health care systems, and the rise in multidrug-resistant disease, as the incidence of leprosy remains stable, at around 250,000 new cases annually, regardless of effective antibiotic therapy. Presentations? of various cutaneous infections caused by mycobacteria may be overlooked by clinicians owing the lack of familiarity with tuberculosis, leprosy, and the related ?NTM clinical features. This handy guide will help? the dermatologist to spot the different clinical manifestations, make a prompt diagnosis, and apply effective treatment.
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Table of Contents:
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Contributors
1: Mycobacteria
1. 1 Habitat and?Diffusion
1. 2 Cellular Structure
1. 3 Antigenic Structure
1. 4 Sensitivity to?Antibiotics
1. 5 Nontubercular Bacteria
1. 6 Classification
1. 7 Complexes
1. 8 Microscopic Examination
1. 9 Culture Media
1. 10 Biological Testing
1. 11 Identification
1. 12 Rapid Methods
References
2: Cutaneous Tuberculosis
2. 1 History
2. 2 Epidemiology
2.
2. 1 Impact of?the?HIV Epidemic
2.
2. 2 Impact of?Drug and?Multidrug Resistance
2.
2. 3 Impact of?Solid Organ Transplantation
2. 3 Risk Factors
2.
3. 1 Immunosuppressive Drugs and?Corticosteroids
2.
3. 2 Age and?Sex
2.
3. 3 Contact Tracing
2.
3. 4 Occupational Tuberculosis
2.
3. 5 Tuberculosis and?Air Travel
2.
3. 6 Genetic Factors
2.
3. 7 Other Factors
2. 4 Etiology
2.
4. 1 Mycobacterium tuberculosis Complex
2.
4.
1. 1 Mycobacterium africanum
2.
4.
1. 2 Mycobacterium caprae
2.
4.
1. 3 Mycobacterium microti
2.
4.
1. 4 Mycobacterium pinnipedii
2.
4.
1. 5 Mycobacterium canettii
2. 5 Transmission
2. 6 Pathophysiology
2.
6. 1 Human Pulmonary Tuberculosis
2.
6. 2 Stages of?Pulmonary Tuberculosis
2.
6. 3 Susceptibility to?Tuberculosis
2.
6. 4 Primary and?Post-Primary Tuberculosis
2. 7 Immunology
2.
7. 1 Cell-Mediated Immunity
2.
7. 2 Innate Immune Response
2. 8 Laboratory Diagnosis
2.
8. 1 Bacteriological Identification
2.
8.
1. 1 Specimen Collection
2.
8.
1. 2 Culture
Solid Media
Broth Media
2.
8.
1. 3 Staining Procedure
2.
8. 2 Radiological Imaging
2.
8. 3 Hematological Examination
2.
8. 4 Molecular Methods
2.
8. 5 Antimicrobial Susceptibility Testing
2.
8. 6 The Tuberculin Skin Test
2.
8.
6. 1 Mantoux Test
2.
8. 7 Interferon-Gamma Assays
2. 9 Histopathology
2. 10 Cutaneous Tuberculosis
2.
10. 1 Epidemiology
2.
10. 2 Historical Aspects
2.
10. 3 Classification
2.
10. 4 Primary Inoculation Tuberculosis
2.
10. 5 Tuberculosis Verrucosa
2.
10. 6 Scrofuloderma
2.
10. 7 Orificial Ulcerative Tuberculosis
2.
10. 8 Miliary Tuberculosis
2.
10. 9 Lupus Vulgaris
2.
10.
9. 1 Pathogenesis
2.
10.
9. 2 Histopathology
2.
10.
9. 3 Clinical Features
2.
10.
9. 4 Clinical Forms
2.
10.
9. 5 Mucosal Involvement
2.
10.
9. 6 Prognosis and?Complications
2.
10.
9. 7 Diagnosis
2.
10. 10 Tuberculous Gumma
2.
10. 11 Unusual Forms of?Cutaneous Tuberculosis
2.
10. 12 Tuberculids
2.
10.
12. 1 Lichen Scrofulosorum
2.
10.
12. 2 Papulonecrotic Tuberculid
2.
10.
12. 3 Nodular Tuberculids
Erythema Induratum of?Bazin
Nodular Tuberculid
Erythema Nodosum
2.
10.
12. 4 Other Possible Tuberculids
2. 11 Tuberculosis of?the?Oral Cavity
2. 12 Cutaneous Tuberculosis in?Pediatric Age
2.
12. 1 Bacillus Calmette-Gu?rin-Induced Skin Lesions
2. 13 Diagnosis and?Prognosis
2. 14 Management
2.
14. 1 General Measures and?Principles of?Chemotherapy
2.
14. 2 Drugs
2.
14.
2. 1 Isoniazid
2.
14.
2. 2 Rifampicin
2.
14.
2. 3 Pyrazinamide
2.
14.
2. 4 Ethambutol
2.
14.
2. 5 Streptomycin
2.
14. 3 Alternative Drugs in?First-Line Regimens
2.
14. 4 Second-Line Drugs
2.
14. 5 Treatment Regimens
2.
14. 6 Treatment Failure and?Relapse
2.
14. 7 Treatment in?Special Circumstances
2.
14. 8 Therapy of?Multidrug Resistant Tuberculosis
2. 15 Chemoprophylaxis
2. 16 Vaccination
References
3: Mycobacterium bovis Skin Infection
3. 1 The Organism
3. 2 Molecular Typing Methods
3. 3 Epidemiology and?Transmission
3. 4 Clinical Features
3. 5 Susceptibility and?Treatment
3. 6 Control and?Recommendations
References
4: Bacillus Calmette-Gu?rin
4. 1 Immunoprotection Against Tuberculosis
4. 2 BCG Vaccine
4. 3 Immune Response to?BCG Vaccination
4. 4 Efficacy of?BCG
4. 5 Administration and?Side Effects of?BCG
4. 6 Current Use of?BCG
4. 7 New Vaccines Against Tuberculosis
References
5: Leprosy
5. 1 History
5. 2 Epidemiology
5. 3 Modes of?Transmission
5.
3. 1 Modes of?Direct and?Environmental Skin Transmission
5. 4 Mycobacterium leprae and?Armadillos
5.
4. 1 Zoonotic Leprosy
5. 5 Etiology
5.
5. 1 Biological Properties of?Mycobacterium leprae
5.
5. 2 Chemical Composition of?Mycobacterium leprae
5.
5. 3 Bacteriological Aspects
5.
5.
3. 1 Bacterial Index
5.
5.
3. 2 Morphological Index
5.
5.
3. 3 Skin Biopsy Specimens
5.
5.
3. 4 Smears of?Nasal Secretions
5.
5. 4 Biochemistry of?Mycobacterium leprae
5.
5. 5 Lepromins
5. 6 Transmission
5.
6. 1 Exit Portals
5.
6. 2 Entry Portals
5.
6. 3 Subclinical Infection and?Re-Infection
5.
6. 4 Incubation Period
5.
6. 5 Scientific Investigation and?Antileprosy Campaign
5.
6. 6 Inactivation of?Disease and?Mortality
5. 7 Genetics
5.
7. 1 Major Histocompatibility Complex Genes
5.
7. 2 Non-HLA Genes
5.
7. 3 Genetics of?Leprosy Reactions
5. 8 Immunopathogenesis
5.
8. 1 Innate Immune Response
5.
8. 2 Acquired Immune Response
5.
8. 3 Antibody Responses
5.
8. 4 Cell-Mediated Immune Responses
5.
8. 5 Advances for?New Mycobacterium leprae-Specific Antigens
5.
8. 6 Cytokine Profiles
5.
8. 7 Leprosy Reactions
5.
8. 8 Immunopathology of?Cutaneous Lesions
5.
8. 9 Nerve Damage
5. 9 Classification
5.
9. 1 Clinical Assessment
5.
9. 2 How to?Examine the?Patient
5.
9.
2. 1 Skin
5.
9.
2. 2 Peripheral Nerves
5.
9.
2. 3 Number of?Mycobacterium leprae
5.
9.
2. 4 Lepromin Test
5.
9.
2. 5 Mucosa of?the?Nasal Fossae
5.
9.
2. 6 Other Examinations
5.
9.
2. 7 Classifications Inside the?Spectrum
5. 10 Histopathology
5.
10. 1 Indeterminate Leprosy
5.
10. 2 Histological Criteria That Aid Classification
5.
10.
2. 1 Number of?Bacilli
5.
10.
2. 2 Cellular Composition of?the?Infiltrate
5.
10.
2. 3 Nerve Alterations
5.
10.
2. 4 Epidermis and?Subepidermal Zone
5.
10. 3 Tuberculoid Leprosy
5.
10. 4 Borderline Tuberculoid Leprosy
5.
10. 5 Borderline Borderline Leprosy
5.
10. 6 Borderline Lepromatous Leprosy
5.
10. 7 Lepromatous Leprosy
5.
10. 8 Leprosy Reactions
5.
10.
8. 1 Type 1 Reaction (T1R)
5.
10.
8. 2 Type 2 Reaction (T2R)
5.
10. 9 Particular Forms of?Leprosy
5.
10.
9. 1 Histoid Leprosy
5.
10.
9. 2 Lucio-Latapi Leprosy
5.
10.
9. 3 Lucio-Alvarado Phenomenon
5.
10. 10 Histopathology of?the?Lymph Nodes
5.
10. 11 Histopathology of?the?Internal Organs
5. 11 Serology
5. 12 Clinical Features
5.
12. 1 Indeterminate Leprosy
5.
12. 2 Tuberculoid Leprosy
5.
12. 3 Borderline Leprosy
5.
12.
3. 1 Borderline Tuberculoid Leprosy
5.
12.
3. 2 Mid-Borderline Leprosy
5.
12.
3. 3 Borderline Lepromatous Leprosy
5.
12. 4 Lepromatous Leprosy
5.
12.
4. 1 Skin Lesions
5.
12.
4. 2 Nerve Involvement
5.
12.
4. 3 Other Disturbances
5.
12.
4. 4 Bones
5.
12. 5 Pure Neural Leprosy
5.
12. 6 Wade?s Histoid Leprosy
5.
12. 7 Lucio-Latapi Leprosy
5.
12.
7. 1 Clinical features
5.
12.
7. 2 Histopathology
5.
12.
7. 3 Diagnosis
5. 13 Relapse
5. 14 Leprosy in?Pregnancy
5. 15 Leprosy and?HIV Coinfection
5. 16 Leprosy Reactions
5.
16. 1 Type 1 Reaction
5.
16. 2 Type 2 Reaction
5.
16. 3 Lucio?s Phenomenon
5. 17 Nerve Damage
5.
17. 1 Pain
5.
17. 2 Sensory Component
5.
17. 3 Autonomic Component
5.
17. 4 Motor Component
5. 18 Ocular Leprosy
5.
18. 1 Eyeball Adnexa Changes
5.
18. 2 Leprosy of?the?Surface of?the?Eye
5.
18. 3 Intraocular Changes
5. 19 Ear, Nose and?Throat Involvement
5.
19. 1 The Ear
5.
19. 2 The Nose
5.
19. 3 The Throat
5. 20 Systemic Involvement
5.
20. 1 Lymph Nodes
5.
20. 2 Liver and?Spleen
5.
20. 3 Bones
5.
20. 4 Testicles and?Other Organs
5. 21 Diagnosis and?Prognosis
5. 22 Differential Diagnosis
5.
22. 1 Macular Lesions
5.
22. 2 Plaques and?Annular Lesions
5.
22. 3 Nodules
5.
22. 4 Nerves
5.
22. 5 Eye Involvement
5. 23 Treatment
5.
23. 1 Chemotherapy: First-Line Drugs
5.
23.
1. 1 Dapsone (4,4-Diaminodiphenylsulfone, or DDS)
5.
23.
1. 2 Clofazimine
5.
23.
1. 3 Rifampicin
5.
23. 2 Drug-Resistant Mycobacterium leprae
5.
23. 3 Multidrug Therapy
5.
23. 4 Novel Drugs and?Treatment Regimens
5.
23. 5 Special Treatment Regimens
5.
23. 6 Treatment of?Leprosy Reactions
5.
23.
6. 1 Type 1 Reaction (Reversal Reaction)
5.
23.
6. 2 Type 2 Reaction (Erythema Nodosum Leprosum)
5.
23.
6. 3 Lucio?s Phenomenon
5.
23.
6. 4 Leprosy Reactions in?Pregnancy
5.
23. 7 Surgical Treatment
5.
23.
7. 1 Nerve Surgery
5.
23.
7. 2 Palliative Surgery
5.
23.
7. 3 Surgery of?Sequelae
5. 24 Prophylaxis
5.
24. 1 Chemoprophylaxis
5.
24. 2 Immunoprophylaxis
5. 25 Control
References
6: Nontuberculous Mycobacteria and?Skin Infection
6. 1 Taxonomy
6. 2 Epidemiology
6. 3 Pathogenesis
6. 4 Diagnosis
6. 5 Clinical Features
6.
5. 1 Lymphadenitis
6.
5. 2 Skin and?Soft Tissue Disease
6. 6 Prevention
6. 7 Transplant Recipients
6. 8 HIV-Infected Individuals
6. 9 Treatment
References
7: Mycobacterium scrofulaceum Infection
7. 1 The Organism
7. 2 Epidemiology
7. 3 Clinical Features
7.
3. 1 Lymphadenitis
7.
3. 2 Skin Disease
7. 4 Histopathology
7. 5 Treatment
References
8: Rapidly Growing Mycobacteria and?Skin Infection
8. 1 Taxonomy
8. 2 Epidemiology
8. 3 Cutaneous and?Subcutaneous Clinical Infection
8. 4 Mycobacterium abscessus
8.
4. 1 Clinical Features
8.
4. 2 Histopathological Remarks
8.
4. 3 Treatment
8. 5 Mycobacterium chelonae
8.
5. 1 Clinical Features
8.
5. 2 Culture and?Histopathology
8.
5. 3 Treatment
8. 6 Mycobacterium fortuitum
8.
6. 1 Clinical Features
8.
6. 2 Histopathology
8.
6. 3 Treatment
8. 7 Diagnosis
References
9: Mycobacterium marinum Skin Infection
9. 1 Taxonomy
9. 2 Genetics
9. 3 Microbiology
9. 4 Pathogenesis
9. 5 Epidemiology
9. 6 Clinical Features
9.
6. 1 Disease in?Fish
9.
6. 2 Disease in?Humans
9. 7 Diagnosis and?Differential Diagnosis
9. 8 Histopathology
9. 9 Treatment
9. 10 Surgery
9. 11 Prevention
9. 12 Personal Data
9. 13 Mycobacterium marinum and?Sea-Urchin Granulomas
9. 14 Piscine and?Aquarium Mycobacteriosis
References
10: Mycobacterium ulcerans Infection
10. 1 History
10. 2 Epidemiology
10. 3 The Organism
10. 4 Ecology and?Route of?Transmission
10. 5 Pathogenesis
10. 6 Clinical Manifestations
10. 7 Histopathology
10. 8 Laboratory Tests
10. 9 Diagnosis
10. 10 HIV Infection and?Mycobacterium ulcerans Infection
10. 11 Treatment
10. 12 Prevention
References
11: Other Nontuberculous Mycobacteria and?Skin Infection
11. 1 Mycobacterium avium Complex
11. 2 Mycobacterium kansasii
11. 3 Mycobacterium haemophilum
11. 4 Mycobacterium gordonae
11. 5 Mycobacterium malmoense
11. 6 Mycobacterium smegmatis
11. 7 Mycobacterium szulgai
References
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