A case of Mycobacterial abscessus infection-induced infectious granuloma of the gluteal region following abdominal wall abscess surgery

doi:10.19871/j.cnki.xfcrbzz.2025.03.012

Abstract

Abstract: This article reports a case of gluteal infectious granuloma secondary to Mycobacterium abscessus infection following abdominal wall abscess surgery. Gluteal infectious granuloma is clinically rare. Furthermore, Mycobacterium abscessus infection exhibits the pathological features of infectious granulomas, but identifying the specific strain is challenging, posing significant difficulties in diagnosis and treatment. In this case, the patient developed a secondary gluteal infection after undergoing surgery for an abdominal wall abscess, with postoperative histopathological acid-fast staining showing positive results. The gluteal infection manifested as localized swelling, pain, and progressively worsening granuloma. After detailed clinical evaluation and laboratory investigations, the patient was ultimately diagnosed with Mycobacterium abscessus infection. After treatment, the patient underwent targeted anti-infective therapy combined with surgical intervention, which gradually brought the condition under control. Through a detailed analysis of this case, this paper aims to provide valuable reference information for clinicians in managing such rare cases, highlighting the importance of early identification and timely treatment while contributing to the accumulation of diagnostic and therapeutic experience for similar conditions.

Key words: Abdominal wall abscess, Mycobacterium abscessus, Gluteal region, Infectious granuloma

CLC Number:

R378.91

Lyu Yansi, Zhao Limei, Guan Lyuxin, Wen Ziping, Wang Bin, Hou Suchun, Ma Li. A case of Mycobacterial abscessus infection-induced infectious granuloma of the gluteal region following abdominal wall abscess surgery[J]. Electronic Journal of Emerging Infectious Diseases, 2025, 10(3): 67-71.

References

[1] ZHOU L, MA C, XIAO T, et al.A New Single Gene Differential Biomarker for Mycobacterium tuberculosis Complex and Non-tuberculosis Mycobacteria[J]. Front Microbiol, 2019, 10:1887.
[2] RUNYON EH.Anonymous mycobacteria in pulmonary disease[J]. Med Clin North Am, 1959, 43(1):273-90.
[3] WOLINSKY E.Mycobacterial diseases other than tuberculosis[J]. Clin Infect Dis, 1992, 15(1):1-10.
[4] KANAMORI H, WEBER DJ, RUTALA WA.Healthcare Outbreaks Associated With a Water Reservoir and Infection Prevention Strategies[J]. Clin Infect Dis, 2016, 62(11):1423-1435.
[5] CRIST MB, PERZ JF.Modern Healthcare Versus Nontuberculous Mycobacteria:Who Will Have the Upper Hand?[J]. Clin Infect Dis, 2017, 64(7):912-913.
[6] 王桂荣, 黄海荣. 非结核分枝杆菌的分布和生长影响因素及其传播途径研究[J]. 中国防痨杂志, 2016, 38(10):869-873.
[7] WALLACE RJ, BROWN BA, GRIFFITH DE.Nosocomial outbreaks/pseudo-outbreaks caused by nontuberculous mycobacteria[J]. Annu Rev Microbiol, 1998, 52:453-490.
[8] FALKINHAM JO.Environmental sources of nontuberculous mycobacteria[J]. Clin Chest Med, 2015, 36(1):35-41.
[9] WU ML, AZIZ DB, DARTOIS V, et al.NTM drug discovery: status, gaps and the way forward[J]. Drug Discovery Today, 2018, 23(8):1502-1519.
[10] ADJEMIAN J, OLIVIER KN, SEITZ AE, et al.Prevalence of nontuberculous mycobacterial lung disease in U.S. Medicare beneficiaries[J]. Am J Respir Crit Care Med, 2012, 185(8):881-886.
[11] JOHANSEN MD, HERRMANN JL, KREMER L.Non-tuberculous mycobacteria and the rise of Mycobacterium abscessus[J]. Nat Rev Microbiol, 2020, 18(7):392-407.
[12] GRIFFITH DE, AKSAMIT T, BROWN-ELLIOTT BA, et al.An official ATS/IDSA statement:diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases[J]. Am J Respir Crit Care Med, 2007, 175(4):367-416.
[13] FLOTO RA, OLIVIER KN, SAIMAN L, et al.US Cystic Fibrosis Foundation and European Cystic Fibrosis Society consensus recommendations for the management of non-tuberculous mycobacteria in individuals with cystic fibrosis:executive summary[J]. Thorax, 2016, 71(1):88-90.
[14] CRISTANCHO-ROJAS C, VARLEY CD, LARA SC, et al.Epidemiology of Mycobacterium abscessus[J]. Clin Microbiol Infect, 2024, 30(6):712-717.
[15] MEI Y, ZHANG W, SHI Y, et al.Cutaneous Tuberculosis and Nontuberculous Mycobacterial Infections at a National Specialized Hospital in China[J]. Acta Derm Venereol, 2019, 99(11):997-1003.
[16] BOUDEHEN YM, KREMER L.Mycobacterium abscessus[J]. Trends Microbiol, 2021, 29(10):951-952.
[17] 徐园红, 吴张君, 罗槑, 等. 四川地区儿童分枝杆菌感染及耐药情况分析[J/CD]. 新发传染病电子杂志, 2023, 8(1):39-43.
[18] BURGESS W, MARGOLIS A, GIBBS S, et al.Disinfectant Susceptibility Profiling of Glutaraldehyde-Resistant Nontuberculous Mycobacteria[J]. Infect Control Hosp Epidemiol, 2017, 38(7):784-791.
[19] KWAK N, DALCOLMO MP, DALEY CL, et al.Mycobacterium abscessus pulmonary disease:individual patient data meta-analysis[J]. Eur Respir J, 2019, 54(1):1801991.
[20] CHOI H, JHUN BW, KIM SY, et al.Treatment outcomes of macrolide-susceptible Mycobacterium abscessus lung disease[J]. Diagn Microbiol Infect Dis, 2018, 90(4):293-295.
[21] KOH WJ, JEONG BH, KIM SY, et al.Mycobacterial Characteristics and Treatment Outcomes in Mycobacterium abscessus Lung Disease[J]. Clin Infect Dis, 2017, 64(3):309-316.
[22] CULLEN AR, CANNON CL, MARK EJ, et al.Mycobacterium abscessus infection in cystic fibrosis. Colonization or infection?[J]. Am J Respir Crit Care Med, 2000, 161(2 Pt 1):641-645.
[23] JÖNSSON BE, GILLJAM M, LINDBLAD A, et al. Molecular epidemiology of Mycobacterium abscessus, with focus on cystic fibrosis[J]. J Clin Microbiol, 2007, 45(5):1497-1504.
[24] CATHERINOT E, ROUX AL, MACHERAS E, et al.Acute respiratory failure involving an R variant of Mycobacterium abscessus[J]. J Clin Microbiol, 2009, 47(1):271-274.
[25] 董宇杰, 李琨, 刘子臣, 等. 非结核分枝杆菌肺病的临床病理特征及分子病理诊断[J]. 诊断病理学杂志, 2024, 31(7):599-602.
[26] 梅琳, 陈华, 张妍蓓, 等. 21例肺诺卡菌病临床特征及耐药性分析[J/CD]. 新发传染病电子杂志, 2024, 9(4):34-38.
[27] YING C, ZHANG L, JIN X, et al.Advances in diagnosis and treatment of non-tuberculous mycobacterial lung disease[J]. Diagn Microbiol Infect Dis, 2024, 109(2):116254.
[28] 蔡慧君, 汤正好. 非结核分枝杆菌的感染现状与诊断方法研究进展[J]. 中国临床医学, 2023, 30(5):900-907.
[29] 梅金周, 王云霞, 张梅娟, 等. 全基因组测序技术在耐药肺结核诊断中的应用性评价[J/CD]. 新发传染病电子杂志, 2024, 9(3):16-20.
[30] JOHNSON TM, BYRD TF, DRUMMOND WK, et al.Contemporary Pharmacotherapies for Nontuberculosis Mycobacterial Infections:A Narrative Review[J]. Infect Dis Ther, 2023, 12(2):343-365.
[31] NESSAR R, CAMBAU E, REYRAT JM, et al.Mycobacterium abscessus:a new antibiotic nightmare[J]. J Antimicrob Chemother, 2012, 67(4):810-818.
[32] BROWN-ELLIOTT BA, VASIREDDY S, VASIREDDY R, et al.Utility of sequencing the erm(41) gene in isolates of Mycobacterium abscessus subsp. abscessus with low and intermediate clarithromycin MICs[J]. J Clin Microbiol, 2015, 53(4):1211-1215.
[33] LUTHRA S, ROMINSKI A, SANDER P.The Role of Antibiotic-Target-Modifying and Antibiotic-Modifying Enzymes in Mycobacterium abscessus Drug Resistance[J]. Front Microbiol, 2018, 9:2179.
[34] YANG JH, WANG PH, PAN SW, et al.Treatment Outcome in Patients with Mycobacterium abscessus Complex Lung Disease:The Impact of Tigecycline and Amikacin[J]. Antibiotics, 2022, 11(5):571.
[35] ROTTMAN M, CATHERINOT E, HOCHEDEZ P, et al.Importance of T cells, gamma interferon, and tumor necrosis factor in immune control of the rapid grower Mycobacterium abscessus in C57BL/6 mice[J]. Infect Immun, 2007, 75(12):5898-5907.
[36] KAM JY, HORTLE E, KROGMAN E, et al.Rough and smooth variants of Mycobacterium abscessus are differentially controlled by host immunity during chronic infection of adult zebrafish[J]. Nat Commun, 2022, 13(1):952.
[37] DORHOI A, REECE ST, KAUFMANN SHE.For better or for worse:the immune response against Mycobacterium tuberculosis balances pathology and protection[J]. Immunol Rev, 2011, 240(1):235-251.