Mycobacterium chelonae bloodstream infection induced by osteomyelitis of toe: A case report

Mycobacterium chelonae is a rapidly growing mycobacterium that has the potential to cause refractory infections in humans. Mycobacteremia resulting from the organism is extremely rare, and its clinical features are yet to be uncovered. We herein present a case of M. chelonae bloodstream infection involving an immunocompromised older patient. A 79-year-old woman, on a long-term treatment with prednisolone plus tacrolimus for rheumatoid arthritis, visited our outpatient department complaining of deteriorating pain and swelling at her right 1st toe. Laboratory parameters showed elevated C-reactive protein and leukocytosis, and magnetic resonance imaging indicated osteomyelitis at the proximal phalanx of her right 1st toe. Considering the refractory course, the infected toe was immediately amputated. M. chelonae was isolated from bacterial cultures of the resected tissue and blood (BD BACTEC™ FX blood culture system, Becton Dickinson, Sparks, MD, USA), leading to a diagnosis of disseminated M. chelonae infection. We treated the patient with an antibiotic combination of clarithromycin, minocycline, and imipenem (2 weeks), which was converted to oral therapy of clarithromycin, doxycycline, and levofloxacin. This case highlighted the potential pathogenesis of M. chelonae to cause mycobacteremia in an immunocompromised patient

ヒドロキシウレアの安定性およびその比色測定に及ぼす2,3の物質の影響

By colorimetry of hydroxyurea and hydroxylamine with 8-hydroxyquinoline, it was found that hydroxylamine was formed from hydroxyurea by heating. The formation was enhanced at higher temperature and by addition of hydrochloric acid. On the other hand, hydroxylamine as well as hydroxyurea was remarkably decreased by heating in alkaline media. Coloration of several substances with the same reagent was also examined. Substances examined were urea, methyl alcohol, ethyl alcohol, ammonium hydroxide, sodium hydroxide, potassium hydroxide, phenylhydrazine, uric acid, phenylthiourea and isonicotinic acid hydrazide besides hydroxylamine and hydroxyurea. All they had no effect on colorimetry of hydroxylamine, while hydroxylamine and phenylhydrazine disturbed the estimation of hydroxyurea.ヒドロキシウレアを加熱すると,ヒドロキシルアミンを生成することが8-ヒドロキシキノリンによる呈色反応から認められた.しかもこのヒドロキシルアミンの生成は高温ないし塩酸酸性で顕著であつたが,アルカリ性においてはヒドロキシウレアならびに生成したヒドロキシルアミンはいずれも減少した.ヒドロキシウレア,ヒドロキシルアミンのほか尿素,メタノール,エタノール,アンモニア,水酸化ナトリウム,水酸化カリウム,フェニルヒドラジン,尿酸,フェニルチオ尿酸およびイソニコチン酸ヒドラジドについても8-ヒドロキシキノリンによつて発色させ,その吸収スペクトルを検討した.その結果この試薬によるヒドロキシウレアの比色定量はヒドロキシルアミンおよびフェニルヒドラジンによる妨害は免れないが,他のものによる顕著な影響は考えられない.一方ヒドロキシルアミンの定量はヒドロキシウレア,フエニルヒドラジンを含み,試験したいずれの物質によつても妨害されないことが確められた

Stability of Hydroxyurea and Effect of Some Substances on Its Colorimetry

By colorimetry of hydroxyurea and hydroxylamine with 8-hydroxyquinoline, it was found that hydroxylamine was formed from hydroxyurea by heating. The formation was enhanced at higher temperature and by addition of hydrochloric acid. On the other hand, hydroxylamine as well as hydroxyurea was remarkably decreased by heating in alkaline media. Coloration of several substances with the same reagent was also examined. Substances examined were urea, methyl alcohol, ethyl alcohol, ammonium hydroxide, sodium hydroxide, potassium hydroxide, phenylhydrazine, uric acid, phenylthiourea and isonicotinic acid hydrazide besides hydroxylamine and hydroxyurea. All they had no effect on colorimetry of hydroxylamine, while hydroxylamine and phenylhydrazine disturbed the estimation of hydroxyurea.ヒドロキシウレアを加熱すると,ヒドロキシルアミンを生成することが8-ヒドロキシキノリンによる呈色反応から認められた.しかもこのヒドロキシルアミンの生成は高温ないし塩酸酸性で顕著であつたが,アルカリ性においてはヒドロキシウレアならびに生成したヒドロキシルアミンはいずれも減少した.ヒドロキシウレア,ヒドロキシルアミンのほか尿素,メタノール,エタノール,アンモニア,水酸化ナトリウム,水酸化カリウム,フェニルヒドラジン,尿酸,フェニルチオ尿酸およびイソニコチン酸ヒドラジドについても8-ヒドロキシキノリンによつて発色させ,その吸収スペクトルを検討した.その結果この試薬によるヒドロキシウレアの比色定量はヒドロキシルアミンおよびフェニルヒドラジンによる妨害は免れないが,他のものによる顕著な影響は考えられない.一方ヒドロキシルアミンの定量はヒドロキシウレア,フエニルヒドラジンを含み,試験したいずれの物質によつても妨害されないことが確められた