Short, occasionally curved, gram-positive, nonmotile and strongly acid-fast rods.

Colony characteristics

• Nonpigmented and rough to smooth colonies.

Physiology

• Media have to be supplemented with 0.4% haemoglobin or 60µM hemin (factor X) or 15mg/ml ferric ammonium citrate respectively, but not with FeCl3 or catalase.
• Slow growth on Löwenstein-Jensen media or Middlebrook 7H10 agar at 32°C within 2-4 weeks.
• Growth slower at 25°C and 35°C and absent at 37°C.
• Strictly intracellular growth in tissue cultures of fibroblasts.

Differential characteristics

• Unique among mycobacteria in its requirement for hemin or ferric ammonium citrate for growth.

Distribution.

• Infects patients with suppressed immune systems.
• Clinical presentation: multiple skin nodules occurring in clusters or without definitive pattern, commonly involving the extremities. Abscesses, draining fistulas and osteomyelitis may be associated with the nodules. Paediatric patients with localised cervical lymphadenopathy.
• Biosafety level 2

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.

• 1. In vitro ^[1]

• Susceptible: Amikacin, Clarithromycin, Ciprofloxacin, Rifampin, and Rifabutin
• Less susceptible: Doxycycline and Sulfonamides

• 2. Disseminated disease

• Preferred regimen: Clarithromycin AND Rifampin AND Rifabutin AND Ciprofloxacin

• Sompolinsky et al. 1978. Mycobacterium haemophilum sp. nov., a new pathogen of humans. International Journal of Systematic Bacteriology, 28, 67-75.

de:Mycobacterium haemophilum nl:Mycobacterium haemophilum

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