Journal List > J Korean Ophthalmol Soc > v.52(3) > 1008999

Jeong: A Case of Skin Infection Caused by Nontuberculous Mycobacterium after External Dacryocystorhinostomy

Abstract

Purpose

To report a case of skin infection caused by nontuberculous mycobacterium after external dacryocystorhinostomy.

Case summary

A 53-year-old female patient presented to our clinic with a tear on the left eye, although a silicone tube was intubated. Two weeks after external dacryocystorhinostomy, swelling and redness were found on the operation wound. Therefore, the patient received oral antibiotics and steroid treatments but did not improve. The mass was irregu-larly shaped and became larger; thus, excisional biopsy was performed at 2 months after external dacryocystorhinostomy. A chronic granulomatous tissue was detected in the excisional biopsy, and antimycobacterial medications were started in consultation with an internist. A moderate colony was observed, and rod-shaped bacteria Mycobacterium abscessus was found in the culture 47 days after acid-fast culture was performed. The patient was diagnosed with a periocular infection caused by nontuberculous mycobacterium. Finally, the lesion improved.

Conclusions

Although patients with granulomatous tissue receive numerous treatments, if the lesion is not improved, then additional excisional biopsy and culture examination to identify infection by nontuberculous mycobacterium are necessary.

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Figure 1.
A 53-year-old woman with multiple elevated erythematous lesions 4 weeks after external dacryocystorhinostomy.
jkos-52-350f1.tif
Figure 2.
Excisional biopsy.
jkos-52-350f2.tif
Figure 3.
(A) Histopathologic examination showing granulomatous inflammation with areas of necrosis and a microabscess (stain, hematoxylin and eosin; magnification, ×400). (B) Acid-fast bacilli (stain, Ziehl Neelsen; magnification, ×400).
jkos-52-350f3.tif
Figure 4.
A decreased erythematous granulomatous lesions 2 months after excisional biopsy and anti-tuberculosis treatment.
jkos-52-350f4.tif
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