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| Fig. 30.8 Infections with atypical mycobacteria. A, Infection caused by M. fortuitum. Erythematous plaque with ulceration and necrosis following a puncture wound. B, Numerous abscesses and nodules caused by M. chelonei infection. (Courtesy of James E. Fitzpatrick, MD.) |
Tattoo-associated infections have been described secondary to
M. chelonae. Numerous patients have been reported in the literature with pruritic papules and pustules restricted to the gray parts of their tattoos. The gray wash was prepared by dilution of black pigment with tap water. Treatment with clarithromycin, azithromycin, tobramycin, or macrolide antibiotics resulted in a favorable outcome. Similarly, outbreaks of furunculosis from contaminated tap water whirlpool baths in nail salons have also been associated with
M. chelonae and M. fortuitum (Fig. 30-8). Thirty-four patients with cutaneous abscesses following liposuction performed by a single physician were found to be infections of
M. chelonae. The tap water in the office was the source.
Drage LA, Ecker PM, Orenstein R, et al: An outbreak of Mycobacterium chelonae infections in tattoos,
J Am Acad Dermatol 62:501– 506, 2010. [Epub ahead of print.]
