Disseminated cutaneous infection with Mycobacterium abscessus in a patient with a low CD4+ T cell count.

We report an uncommon case of disseminated cutaneous infection with Mycobacterium abscessus. The patient was a 22-year-old female with low level of CD4+ T cells in the peripheral blood cells, who presented with a number of tender red nodules, erythema and erythematous infiltrated plaques on her cheek, neck and extremities. Colonies without pigment grew after incubating on Löwenstein-Jensen (L-J) medium at 37 degrees C and 32 degrees C for 3-5 days. Polymerase chain reaction (PCR) amplification of the hsp65 gene and the pattern of PCR-restriction fragment length polymorphism (PCR-RFLP) on the isolated strain showed it was M. abscessus. The similarity of hsp65, 16SrRNA gene between the isolate and the M. abscessus reference strain were 99.75% and 100% respectively. After the patient had been treated with rifampin, isoniazid, ofloxacin, clarithromycin and thymosin for 6 months, the skin lesions were greatly improved and the level of CD4+ T cells in the peripheral blood cells became normal.