Mycobacterium haemophilum

Mycobacterium haemophilum
Scientific classification Edit this classification
Domain: Bacteria
Kingdom: Bacillati
Phylum: Actinomycetota
Class: Actinomycetes
Order: Mycobacteriales
Family: Mycobacteriaceae
Genus: Mycobacterium
Species:
M. haemophilum
Binomial name
Mycobacterium haemophilum
Sompolinsky et al. 1978, ATCC 29548

Mycobacterium haemophilum is a Gram-positive, acid-fast bacterium in the phylum Actinomycetota. It was first isolated in 1978 from a subcutaneous lesion in a Hodgkin’s disease patient. [1]

The species name, haemophilum, means "blood loving", and refers to the bacterium's unique iron requirement for growth. [2]

It is frequently found in the environment, although its exact habitat remains unknown, where it can colonize and potentially infect humans and animals. [3] [4]

Microbiology

M. haemophilum are short, occasionally curved, gram-positive, nonmotile and strongly acid-fast rods that are 1.2 μm to 2.5 μm in length. They have nonpigmented and rough to smooth colonies that can take up to 8 weeks to exhibit visible growth.[1][3] Like M. tuberculosis, M. haemophilum has the ability to exhibit strings, proving that cord formation should no longer be attributed exclusively to M. tuberculosis.[5]

M. haemophilum is unique among mycobacteria in its requirement for hemin or ferric ammonium citrate for growth, as well as for favoring the lower growth temperatures of 25- 35°C.[1][3] The pathogenicity of M. haemophium appears to be temperature dependent, consistent with the fact that most infections occur on the skin and other sites with lower body temperature. [6][7]

Mycobacterium leprae and M. haemophilum have similar abundances of the fatty acid docosanoic acid, and M. haemophilum contains a phenolic glycolipid antigen that closely resembles the corresponding lipid in M. leprae.[8] Additionally, M. leprae has major membrane protein I, which is absent in the M. tuberculosis complex, but is present in M. haemophilum, as well as M. avium and M. smegmatis. [9]

Optimal detection of M. haemophilum involves acid-fast staining, culturing at two temperatures with iron-containing media and molecular detection. Failure to isolate a pathogen in clinical samples with positive acid-fast stains under typical conditions should raise suspicion for M. haemophilum infection and appropriate growing conditions or molecular detection should be utilized. [3]

Clinical Relavance

M. haemophilum primarily infects immunocompromised patients, and approximately 50% of infections have been in paitents with AIDS.[1][4][10] However, there have been reports of infections in immunocompetent pediatric patients with localized cervical lymphadenopathy. [11][12]

In contrast to M. tuberculosis infection, M. haemophilum is not a reportable infection, thus, the true number of cases may be higher than indicated by case reports.[3]

The classical clinical presentation includes multiple skin nodules occurring in clusters or without definitive pattern, commonly involving the extremities. The skin lesions usually evolve from papules to asymptomatic pustules, to very painful deep-seated ulcers.[13] Abscesses, draining fistulas and osteomyelitis may be associated with the nodules. [1] Occasionally, disseminated and pulmonary infections can occur. [3]

Cutaneous and articular manifestations of M. haemophilum infection have a more favorable prognosis than infections with pulmonary involvement. [14]

M. haemophilum infection is not limited to humans; infections have also been reported in fish, snakes and bison. [15][16][17]

There are no standard guidelines for treatment of M. haemophilum, however, it is suggested that patients be treated with multiple antibiotics, with the antibiotic choice relying on the degree of immunosuppression and disease presentation. A combination of clarithromycin, ciprofloxacin, and a rifamycin for 12 to 24 months is particularly promising.[14][18] Overall, M. haemophilum appears to be susceptible to ciprofloxacin, clarithromycin, rifabutin, and clofazimine. Isoniazid and ethambutol resistance has been noted.[19] [20][21] A disk agar elution method for M. haemophilum has been proposed by CLSI. [22]

Type strain

First isolated in Israel from a subcutaneous granuloma from a patient with Hodgkin's disease. An environmental reservoir is presumed. Strain ATCC 29548 = CCUG 47452 = CIP 105049 = DSM 44634 = NCTC 11185.

References

  1. 1 2 3 4 5 Versalovic, James (2011). Manual of clinical microbiology (10th ed.). Washington (D.C.): ASM press. ISBN 978-1-55581-463-2.
  2. ↑ "Species: Mycobacterium haemophilum". lpsn.dsmz.de. Retrieved 2026-07-24.
  3. 1 2 3 4 5 6 Lindeboom, Jerome A.; Bruijnesteijn van Coppenraet, Lesla E. S.; van Soolingen, Dick; Prins, Jan M.; Kuijper, Eduard J. (2011). "Clinical Manifestations, Diagnosis, and Treatment of Mycobacterium haemophilum Infections". Clinical Microbiology Reviews. 24 (4): 701–717. doi:10.1128/cmr.00020-11. PMC 3194825. PMID 21976605.
  4. 1 2 Martinelli, C; Farese, A; Carocci, A; Giorgini, S; Tortoli, E; Leoncini, F (2004). "First case of Mycobacterium haemophilum infection in an AIDS patient in Italy**". Journal of the European Academy of Dermatology and Venereology. 18 (1): 83–85. doi:10.1111/j.1468-3083.2004.00781.x. ISSN 0926-9959.
  5. ↑ Julián, Esther; Roldán, Mónica; Sánchez-Chardi, Alejandro; Astola, Oihane; Agustí, Gemma; Luquin, Marina (2010). "Microscopic Cords, a Virulence-Related Characteristic of Mycobacterium tuberculosis , Are Also Present in Nonpathogenic Mycobacteria". Journal of Bacteriology. 192 (7): 1751–1760. doi:10.1128/JB.01485-09. ISSN 0021-9193. PMC 2838037. PMID 20097851.
  6. ↑ Fischer, L J; Quinn, F D; White, E H; King, C H (1996). "Intracellular growth and cytotoxicity of Mycobacterium haemophilum in a human epithelial cell line (Hec-1-B)". Infection and Immunity. 64 (1): 269–276. doi:10.1128/iai.64.1.269-276.1996. ISSN 0019-9567. PMC 173755. PMID 8557350.
  7. ↑ Fischer, Laura J.; Quinn, Frederick D.; Kikuta‐Oshima, Lynne; Ribot, Efrain M.; King, C. Harold (1996). "Identification of Genes Specifically Expressed by Mycobacterium haemophilum in Association with Human Epithelial Cells". Annals of the New York Academy of Sciences. 797 (1): 277–280. doi:10.1111/j.1749-6632.1996.tb52977.x. ISSN 0077-8923.
  8. ↑ Besra, Gurdyal S.; McNeil, Michael; Minnikin, David E.; Portaels, Francoise; Ridell, Malin; Brennan, Patrick J. (1991-08-01). "Structural elucidation and antigenicity of a novel phenolic glycolipid antigen from Mycobacterium haemophilum". Biochemistry. 30 (31): 7772–7777. doi:10.1021/bi00245a015. ISSN 0006-2960.
  9. ↑ Winter, Nathalie; Triccas, James A.; Rivoire, Becky; Pessolani, Maria Cristina V.; Eiglmeier, Karin; Lim, Eng‐Mong; Hunter, Shirley W.; Brennan, Patrick J.; Britton, Warwick J. (1995). "Characterization of the gene encoding the immunodominant 35 kDa protein of Mycobacterium leprae". Molecular Microbiology. 16 (5): 865–876. doi:10.1111/j.1365-2958.1995.tb02314.x. ISSN 0950-382X.
  10. ↑ Mycobacterium Haemophilum at eMedicine
  11. ↑ Lindeboom, J. A.; Prins, J. M.; Bruijnesteijn van Coppenraet, E. S.; Lindeboom, R.; Kuijper, E. J. (2005-12-01). "Cervicofacial Lymphadenitis in Children Caused by Mycobacterium haemophilum". Clinical Infectious Diseases. 41 (11): 1569–1575. doi:10.1086/497834. ISSN 1058-4838.
  12. ↑ Zeharia, Avraham; Eidlitz-Markus, Tal; Haimi-Cohen, Yishai; Samra, Zmira; Kaufman, Lea; Amir, Jacob (2008). "Management of Nontuberculous Mycobacteria-Induced Cervical Lymphadenitis With Observation Alone". Pediatric Infectious Disease Journal. 27 (10): 920–922. doi:10.1097/INF.0b013e3181734fa3. ISSN 0891-3668.
  13. ↑ Davis, Bryan R.; Brumbach, Joyce; Sanders, William J.; Wolinsky, Emanuel (1982-11-01). "Skin Lesions Caused by Mycobacterium haemophilum". Annals of Internal Medicine. 97 (5): 723–724. doi:10.7326/0003-4819-97-5-723. ISSN 0003-4819.
  14. 1 2 Shah, M. K.; Sebti, A.; Kiehn, T. E.; Massarella, S. A.; Sepkowitz, K. A. (2001-08-01). "Mycobacterium haemophilum in immunocompromised patients". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 33 (3): 330–337. doi:10.1086/321894. ISSN 1058-4838. PMID 11438898.
  15. ↑ Hernandez-Divers, Stephen J.; Shearer, David (2002-06-01). "Pulmonary mycobacteriosis caused by Mycobacterium haemophilum and M marinum in a royal python". Journal of the American Veterinary Medical Association. 220 (11): 1661–1663. doi:10.2460/javma.2002.220.1661. ISSN 0003-1488.
  16. ↑ Jacob, B.; DeBey, B. M.; Bradway, D. (2006). "Spinal Intradural Mycobacterium haemophilum Granuloma in an American Bison ( Bison bison )". Veterinary Pathology. 43 (6): 998–1000. doi:10.1354/vp.43-6-998. ISSN 0300-9858.
  17. ↑ Kent, Michael L.; Whipps, Christopher M.; Matthews, Jennifer L.; Florio, Daniela; Watral, Virginia; Bishop-Stewart, Janell K.; Poort, Melanie; Bermudez, Luiz (2004). "Mycobacteriosis in zebrafish (Danio rerio) research facilities". Comparative Biochemistry and Physiology Part C: Toxicology & Pharmacology. 138 (3): 383–390. doi:10.1016/j.cca.2004.08.005.
  18. ↑ Saubolle, M. A.; Kiehn, T. E.; White, M. H.; Rudinsky, M. F.; Armstrong, D. (1996). "Mycobacterium haemophilum: microbiology and expanding clinical and geographic spectra of disease in humans". Clinical Microbiology Reviews. 9 (4): 435–447. doi:10.1128/CMR.9.4.435. ISSN 0893-8512. PMC 172903. PMID 8894345.
  19. ↑ Males, B M; West, T E; Bartholomew, W R (1987). "Mycobacterium haemophilum infection in a patient with acquired immune deficiency syndrome". Journal of Clinical Microbiology. 25 (1): 186–190. doi:10.1128/jcm.25.1.186-190.1987. ISSN 0095-1137. PMC 265858. PMID 3793874.
  20. ↑ Moulsdale, M.T.; Harper, J.M.; Thatcher, G.N.; Dunn, B.L. (1983). "Infection by Mycobacterium haemophilum, a metabolically fastidious acid-fast bacillus". Tubercle. 64 (1): 29–36. doi:10.1016/0041-3879(83)90047-8.
  21. ↑ Shah, M. K.; Sebti, A.; Kiehn, T. E.; Massarella, S. A.; Sepkowitz, K. A. (2001-08-01). "Mycobacterium haemophilum in immunocompromised patients". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 33 (3): 330–337. doi:10.1086/321894. ISSN 1058-4838. PMID 11438898.
  22. ↑ Woods, Gail (2011). Susceptibility testing of mycobacteria, nocardiae, and other aerobic actinomycetes (2nd ed.).
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