Mycobacterium marinumによる頬部皮膚疾患の1例 : 主としてその細菌学的方面について

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Recently these authors have encountered a case of Mycobacterium marinum skin infection not related to exposure in a contaminated swimming pool. Since the skin disease due to the organism of this species is relatively rare in Japan, a rather detailed bacteriological study was made. A 71-year-old woman fell on the cemented floor at a fish shop in Hiroshima and abraded her right bucca in October, 1971. When she was seen about ten days after the injury, there was reddened, swollen, well demarcated induration with a number of pustules on the bucca. By taking the various antimicrobial agents and steroid hormones, the lesions were slightly improved. A submandibular lymph node was swollen in November incised and drained on December 14. On February 29, 1972, she began taking kanamycin in a dose of 0.5g every other day by injection, which promptly improved lesions. A chest roentgenogram showed no evidence of tuberculosis. A tuberculin test gave positive reaction. Punch biopsy was done on November 17, 1971. Biopsy showed slight hyperkeratosis and parakeratosis. Deeper, there was a granulomatous inflammatory reaction with histiocyte-like cells, lymphocytes and giant cells. Ziehl-Neelsen stain revealed no acid-fast rods. Pus specimens were inoculated directly onto nutrient agar and/or Sabouraud agar and incubated at 27°C. From the buccal lesions acid-fast bacilli were isolated on November 17 and 27 and December 14, 1971. From the submandibular lymph node similar acid-fast organisms were isolated on January 6, 1972. In all cases, the colonies appeared in from two to three weeks after inoculation, as white, moist, slightly elevated, smooth areas, having irregular margin. They have the characteristic of changing color from white to yellow following exposure to light. Three of four strains isolated were submitted to the various biological and biochemical tests. At first transfers good growth occured at 30μ, 37μ and 22μ and the days required for visible growth were 5, 7, and 8 to 9 days, respectively. No growth was obtained at 40°C in two weeks. All strains were negative for niacin and nitrate reduction tests, while positive for Tween 80 hydrolysis, catalase, 68°C catalase, acid phosphatase, 70°C acid phosphatase and putrescine-oxydase. The amidase activity was positive for urease, nicotinamidase, pyrazina midase and allantoinase, whereas negative for acetamidase, benzamidase, isonicotinamidase, salicylamidase, succinamidase, malonamidase, propionamidase, acrylamidase and oxamidase. Each of five female mice (#CF 1) was injected intravenously with 5.8×107 viable units of the Irita I strain isolated on November 27, 1971. During the experiment nodular swellings covered with scales or crusts were seen on their tails. All of the animals died in from nine to thirteen days after infection. No grossly visible disease was noted on the visceral organs. A large number of organisms were recovered from the tail, and the moderate to numerous number of organisms from lungs, liver, kidneys and spleen. In summary, the biological and biochemical characteristics as well as the mouse pathoge nicity of the organism reported in this paper are compatible with those of M. marinum strain.
日本結核病学会の論文

<I>Mycobacterium marinum</I>による頬部皮膚疾患の1例 : 主としてその細菌学的方面について

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