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| Fig. 30.7 Mycobacterium aviumintracellulare infection presenting as nodules and ulcerations in an HIV-infected patient. (Courtesy of Margaret Muldrow, MD.) |
Mycobacterium avium complex (MAC) includes
M. avium, M. intracellulare, and other unidentified species, although it has recently become clear that M. avium is the most common cause. These organisms have gained importance with the epidemic of HIV infection. HIV-negative persons most commonly present with pulmonary involvement. Cutaneous disease is rare but may occur as a manifestation of primary intracutaneous inoculation or disseminated disease. The cutaneous lesions are quite variable and include ulcers, abscesses, deep nodules, or inflammatory plaques (Fig. 30-7). Eighty percent to 90% of childhood lymphadenitis is caused by MAC. AIDS patients with MAC generally present with widely disseminated disease (pulmonary, lymph node, gastrointestinal tract, bone). Isolated cutaneous disease is unusual but reported.
Bhambri S, Bhambri A, Del Rosso JQ: Atypical mycobacterial cutaneous infections, Dermatol Clin 27(1):63–73, 2009.
