Mycobacterium abscessus is a bacterium that can cause serious skin and soft tissue infections. It is an uncommon cause of human disease, but infections can occur, particularly after skin injury. This bacterium is found widely in the environment.
How the Infection Develops and Spreads
Mycobacterium abscessus naturally exists in environmental sources like water, soil, and dust. Skin infections typically occur when these bacteria enter a break in the skin. This can happen through exposure to contaminated water, such as in spa settings, or during medical and cosmetic procedures.
Infections have been linked to non-sterile injections, tattooing, and various surgical procedures, including plastic surgery, liposuction, and acupuncture. The bacteria are generally not spread from person to person.
Identifying the Signs of Infection
Symptoms of a Mycobacterium abscessus skin infection often emerge weeks to months after exposure. Lesions typically appear as red, tender nodules or abscesses, which may drain pus. They can also present as boils.
These infections can be painful. A key indicator of M. abscessus is their poor response to standard antibiotics. Lesions may range from a single localized spot to multiple, widespread areas, and can resemble other skin conditions.
Understanding Diagnosis and Treatment
Diagnosing a Mycobacterium abscessus skin infection requires specific laboratory tests, as it can mimic other conditions and does not respond to common antibiotics. A skin biopsy or culture from the lesion is usually performed to identify the bacterium. Specialized mycobacterial cultures are necessary, as standard bacterial cultures may yield negative results.
Diagnosis can be delayed, sometimes taking weeks or months, due to the bacterium’s unusual nature and resistance. Once isolated, drug susceptibility testing determines which antibiotics might be effective.
Treating M. abscessus infections is challenging due to its multi-drug resistance. Treatment typically involves a combination of multiple antibiotics, often administered over a long duration, from several months to over a year.
For severe or localized cases, surgical debridement or excision of infected tissue is important. This helps reduce the bacterial load and remove damaged tissue. For widespread infections, intravenous antibiotic therapy may be required. Treatment regimens are complex and often need adjustments due to side effects or lack of effectiveness.
Prevention and Long-Term Outlook
Preventing Mycobacterium abscessus skin infections involves minimizing exposure to contaminated sources, especially with broken skin. Strict sterile techniques are important during medical, surgical, and cosmetic procedures like tattoos or injections. This includes ensuring instruments are properly sterilized and only sterile water or solutions are used.
Proper wound care is also important, as open wounds can serve as entry points for the bacteria. Avoiding non-sterile water sources in high-risk situations, particularly with open wounds, helps reduce risk.
The long-term outlook for M. abscessus skin infections varies based on severity and how quickly treatment begins. While treatable, these infections can be persistent and challenging to eradicate. Scarring or recurrence is possible if the infection is not fully cleared. Close follow-up with healthcare providers is often necessary to monitor resolution and address lasting effects.