DISSEMINATED VARIOLIFORM PUSTULAR ERUPTION DUE TO MYCOBACTERIUM-AVIUM-INTRACELLULARE IN AN HIV-INFECTED PATIENT

Severe disseminated infection due to Mycobacterium avium intracellular e, with unusual cutaneous features, is reported in a patient with acqu ired immunodeficiency syndrome (AIDS). The eruption appeared as dissem inated pustular lesions which showed necrotic features and which led t o varioliform scarring, Bacterial culture from the skin, blood, and bo ne marrow, and ultimately from the bronchoalveolar fluid and sputum, w as positive for M. avium intracellulare. The patient was successfully treated using a multiple agent anti-mycobacterial regimen including cl arithromycin, which appeared to be the most effective drug. This resul ted in resolution of the cutaneous and general symptoms, Our patient i llustrates the wide spectrum of skin presentations that may be seen wi th mycobacterial infections in subjects infected with the human immuno deficiency virus (HIV). Clarithromycin is an important agent for the t reatment of these severe infections.