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Mycobacterial Infections

»	What is the classification system of mycobacteria?
»	What are the staining characteristics of mycobacteria?
»	How many species of Mycobacterium cause infection in human beings?
»	Name three mycobacteria in the tuberculosis complex responsible for tuberculosis.
»	What is tuberculosis?
»	What is the difference between a primary and secondary infection?
»	Explain the route of infection in cutaneous tuberculosis.
»	Who is at risk of acquiring tuberculosis?
»	Describe the histopathologic hallmark of tuberculosis.
»	How can one acquire primary cutaneous tuberculosis?
»	Describe the clinical manifestation of primary-inoculation cutaneous tuberculosis.
»	What are the different types of cutaneous tuberculosis?
»	What laboratory tests are used to diagnose Mycobacterium tuberculosis?
»	Is lupus vulgaris related to lupus erythematosus or lupus pernio?
»	Describe the clinical manifestations of lupus vulgaris.
»	Where and when does lupus vulgaris develop?
»	What is scrofuloderma?
»	Name the vaccination against tuberculosis. What type of vaccination is it?
»	What drugs are used in the treatment of tuberculosis?
»	What are the major side effects of antituberculous agents?
»	What factors have led to multidrug-resistant tuberculosis?
»	Are there any special treatment considerations for cutaneous tuberculosis?
»	What is the mechanism of action of TNF-a in tuberculosis?
»	Describe the pathogenesis of the atypical mycobacteria.
»	Describe the pathogenesis of the atypical mycobacteria.
»	What is a “swimming pool granuloma”?
»	What is a Buruli ulcer?
»	Describe the clinical manifestations of Mycobacterium avium-intracellulare complex (MAC) in both non-AIDS and AIDS patients.
»	Which atypical mycobacteria are associated with mesotherapy?
»	Which atypical mycobacteria are associated with tattoos?
»	Which atypical mycobacteria have been associated with soft tissue fillers?
»	How are infections with rapidly growing mycobacteria managed?
»	What are some of the key features of Mycobacterium kansasii?

Name the vaccination against tuberculosis. What type of vaccination is it?

Bacillus Calmette-Guérin (BCG) is a live attenuated strain of Mycobacterium bovis. It was discovered in 1921, but has not been widely used in the United States, with the exception of a very small number of at-risk infants who cannot receive chemoprophylaxis. In third-world countries, the BCG vaccine is widely used. This vaccination is contraindicated in immunosuppressed individuals who are at risk of disseminated M. bovis infection. Intravesical BCG is also commonly used as treatment for bladder cancer, and there have been reports of cutaneous tuberculous lesions following this therapy.

Hillyer S, Gulmi FA: Cutaneous BCG of the penis after intravesical therapy for bladder cancer: a case report in a 66-year-old male, Can J Urol 16(5):4866–4869, 2009.

Gontero P, Bohle A, Malmstrom PU, et al: The role of Bacillus Calmette-Guérin in the treatment of non–muscle-invasive bladder cancer, Eur Urol 57:410–429, 2010. [Epub ahead of print.]

Ng YH, Bramwell SP, Palmer TJ, Woo WK: Cutaneous mycobacterial infection postintravesical BCG installation, Surgeon 4(1):57–58, 2006.