AN UNUSUAL ACID-FAST INFECTION OF THE KNEE WITH SUBCUTANEOUS, ABSCESS-LIKE LESIONS OF THE GLUTEAL REGION - REPORT OF A CASE WITH A STUDY OF THE ORGANISM, MYCOBACTERIUM-ABSCESSUS, N, SP

[摘要] The lesions produced by the organism differed because of the duration of the primary involvement (48 yrs.) presumed to be a traumatic infection of the knee, the manner of spread of the organism (hematogenous, following surgery), and the type of lesion produced (subcut., abscess-like lesions with a peripherally tuberculoid structure). The organism, Mycobacterium abscessus, belongs to a fairly large group consisting of isolates from soil and water, many of which are referred to as saprophytes, while others produce lesions in cold-blooded animals, and still others are responsible for low-grade infections in man. These lesions showed caseation necrosis and tuberculoid structures suggestive of tuberculosis. In animals, including the chorioallantoic membranes of developing chicks, mice, hamsters, guinea pigs and rabbits, the organism produces lesions which, exclusive of those in the chick membranes, are transient. The organism produces a nodular type of lesion with necrotic centers which in turn become tuberculoid and finally disappear, leaving the animal apparently unaffected. Because (1) it does not produce a progressive disease in either man or animals,(2) tends to disappear from the tissues, apparently ingested by macrophages, and (3) the lesions themselves eventually disappear without causing any apparent lasting damage, this organism is considered to be a mycobacterium of low virulence.