Mycobacterium scrofulaceum

Atypical mycobacterium found in milk, oysters, soil and water. M. scrofulaceum is a rare pathogen of the slow-growing nontuberculous mycobacteria (NTMs) family. M. scrofulaceum can infect any tissue in humans.

In children, the pathogen is found clustered in pediatric cervical lymphadenitis. In adult patients, pulmonary infections are prominent (Suzuki S et al. 2016; Wilson JW et al. 2019) .

Occurring mainly in childhood, after weaning.

In adults, predominantly middle-aged and older men.

Childhood: Cervical lymphadenitis, colliquative skin lesions.

Adulthood: Mostly chronic obstructive pulmonary diseases are present, not infrequently with histories of pulmonary tuberculosis. Frequently, the pathogen has been found in South African gold mine workers (Corbett EL et al 1999). In a major microbiology center, positive M. scrofulaceum cultures were identified in 17 patients over a 15-year period. 10x this finding was associated with clinical infection. These were:

• Pulmonary and pleural infections (4).
• Bone and joint infections with foreign bodies (2)
• Skin and soft tissue infections (2) - clinically uncharacteristic abscessing inflammations.
• brain abscesses (1)
• pediatric cervical adenitis (1).

Immunomodulatory conditions were present in almost all adult patients. Patients with pulmonary or pleural infections frequently had structural lung disease. Disseminated infections by M. scrofulaceum have been observed in HIV-infected individuals (Sanders JW et al 1995). In contrast, M. scrofulaceum is isolated in about 1/3 of patients in urine or respiratory cultures without evidence of clinical disease.

Treatment outcomes are generally favorable; however, prognosis is more guarded in patients with pulmonary M. scrofulaceum disease (Wilson JW et al 2019).

1. Corbett EL et al (1999) Mycobacterium kansasii and M. scrofulaceum isolates from HIV-negative South African gold miners: incidence, clinical significance and radiology. Int J Tuberc Lung Dis 3:501-517.
2. Ishii N et al (1998) A case of mycobacterial skin disease caused by Mycobacterium peregrinum and M. scrofulaceum. Acta Derm Venereol 78:76-77.
3. Sanders JW et al (1995) Disseminated Mycobacterium scrofulaceum infection: a potentially treatable complication of AIDS. Clin Infect Dis 20: 549.
4. Suzuki S et al (2016) Clinical characteristics of pulmonary Mycobacterium scrofulaceum disease in 2001-2011: A case series and literature review. J Infect Chemother 22:611-616.
5. Wilson JW et al (2019) Mycobacterium scrofulaceum disease: experience from a tertiary medical centre and review of the literature. Infect Dis (Lond) 51:602-609.