Xin Ran Li, MD; Devesh Kumar, MD; Amber Y. Bo, MD; Jenna T. Le, BS; Ariana Ellis, MD; Kara Young, MD; Karolyn A. Wanat, MD; Mohan Dhariwal, DO; Pinky Jha, MD; Jaime Green, MD; Sol Aldrete, MD
WMJ. 2024;123(3):233-237.
ABSTRACT
Introduction: Dermatologic manifestations of diseases in solid organ transplant recipients are common due to long-term immunosuppression.
Case Presentation: We present the case of a 63-year-old man with a kidney transplant who exhibited subcutaneous nodules on lower extremities, cytopenia, and asymptomatic pulmonary infiltrate. Through a skin biopsy and 16S ribosomal RNA (rRNA) sequencing, Mycobacterium haemophilum was identified. His clinical course was complicated by empyema, septic arthritis, and recurrence of his skin manifestations, despite ongoing antimicrobial treatment.
Discussion: This case emphasizes the challenges and potential complications associated with M haemophilum infections in solid organ transplant recipients receiving long-term immunosuppressive therapy. It highlights the importance of employing advanced diagnostic techniques when evaluating dermatologic manifestations in these patients. The patient’s complex clinical course also underscores the difficulties involved in effectively addressing and managing complications that may arise even after initiating therapy.