Which physical findings are characteristic of mycobacterium chelonae infection?

Updated: Dec 20, 2018
  • Author: Alfred Scott Lea, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

No physical examination findings are pathognomonic for M chelonae infection. Findings, as follows, depend on infection site and the cause:

  • Skin: Ulcerative lesions and/or subcutaneous nodules may be present. Deep infection may lead to abscess formation and draining sinus tracts. In contrast to Mycobacterium fortuitum infection, the skin lesions caused by M chelonae infection tend to be multiple and tend to occur in older patients or individuals receiving immunosuppressive drugs. [12] The sinus tracts may drain thick purulence, which may appear and disappear over time. Skin involvement is often associated with hyperpigmentation. Lesions are indolent and not particularly warm to the touch. See the image below.

  • Eye: Conjunctivitis, episcleritis, canniculitis, corneal ulcers, dacryocystitis, or keratitis may be present.

  • Lungs: Rales or rhonchi may be present.

  • Heart: Valvular murmur with endocarditis may be present.

  • Abdomen: Diffuse tenderness with peritonitis may be associated with peritoneal dialysis.

Overlying cellulitis, cold abscess formation, late-onset incisional drainage, and/or joint pain/dysfunction suggests prosthetic infection of all types.

Fever, with or without chills, in the presence of intravascular catheters, dialysis catheters, or prosthetic heart valves raises the possibility of bacteremia, particularly in an immunocompromised patient.

Cutaneous lesions from Mycobacterium abscessus. Co Cutaneous lesions from Mycobacterium abscessus. Courtesy of K. Galil, US Centers for Disease Control and Prevention.

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