{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T13:19:14Z","timestamp":1783430354992,"version":"3.54.6"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>\n                    <jats:italic toggle=\"yes\">Mycobacterium haemophilum<\/jats:italic>\n                    is a very rare and slow-growing nontuberculous mycobacteria that affects mainly immunocompromised patients. Only 250 cases have been reported in the literature since its discovery in 1978. We report a case of a 69-year-old female with systemic lupus erythematosus and lupus nephritis on mycophenolate mofetil who presented with worsening skin nodules. The presence of lower limb edema and proteinuria further confounds the clinical picture toward a lupus flare. Despite treatment for a lupus flare, she developed high-grade fever and new skin nodules, posing a clinical dilemma. She had multiple subcutaneous nodules with ecchymosis along the bilateral thighs and dorsum of the left hand down to the left index finger and along the ulnar aspect of the left wrist, without periungual erythema. Skin biopsy revealed granulomatous inflammation with numerous acid-fast bacilli. The organism was subsequently identified as\n                    <jats:italic toggle=\"yes\">M. haemophilum<\/jats:italic>\n                    by matrix-assisted laser desorption\/ionization time-of-flight (MALDI-TOF) mass spectrometry. Clinicians should have a low threshold for suspicion of mycobacterial infection and their cutaneous manifestations in immunocompromised patients. Failure to respond to usual treatments should trigger a skin biopsy in a timely manner. New bacterial identification techniques such as gene sequencing and MALDI-TOF are very useful to identify fastidious organisms and to plot appropriate treatment.\n                  <\/jats:p>","DOI":"10.4103\/ijmy.ijmy_73_26","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T22:16:31Z","timestamp":1782857791000},"page":"171-175","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["A Rare Infection in a Patient with Systemic Lupus Erythematosus Treated with Mycophenolate Mofetil"],"prefix":"10.4103","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2227-2803","authenticated-orcid":false,"given":"Umabalan","family":"Thirupathy","sequence":"first","affiliation":[{"name":"Department of Medicine, Cheshire Medical Center, Keene, New Hampshire, Worcester, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pili","family":"Kamenju","sequence":"additional","affiliation":[{"name":"Department of Medicine, Saint Vincent Hospital, Worcester, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khanjan Rajesh","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Medicine, Saint Vincent Hospital, Worcester, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Houman","family":"Javady","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Saint Vincent Hospital and Reliant Medical Group, Worcester, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"R1-20260707","doi-asserted-by":"crossref","first-page":"e01313","DOI":"10.1128\/mBio.01313-15","article-title":"The complete genome sequence of the emerging pathogen Mycobacterium haemophilum explains its unique culture requirements","volume":"6","author":"Tufariello","year":"2015","journal-title":"mBio"},{"key":"R2-20260707","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1099\/00207713-28-1-67","article-title":"Mycobacterium haemophilum sp. nov., a new pathogen of humans","volume":"28","author":"Sompolinsky","year":"1978","journal-title":"Int J Syst Bacteriol"},{"key":"R3-20260707","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1111\/1346-8138.12948","article-title":"Mycobacterium haemophilum infection with prominent facial manifestation mimicking leprosy","volume":"42","author":"Ishii","year":"2015","journal-title":"J Dermatol"},{"key":"R4-20260707","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1128\/CMR.00020-11","article-title":"Clinical manifestations, diagnosis, and treatment of Mycobacterium haemophilum infections","volume":"24","author":"Lindeboom","year":"2011","journal-title":"Clin Microbiol 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Dis"},{"key":"R8-20260707","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1111\/j.1473-2165.2011.00564.x","article-title":"Nodular skin reactions in eyebrow permanent makeup: Two case reports and an infection by Mycobacterium haemophilum","volume":"10","author":"Wollina","year":"2011","journal-title":"J Cosmet Dermatol"},{"key":"R9-20260707","doi-asserted-by":"crossref","first-page":"1098047","DOI":"10.3389\/fmed.2023.1098047","article-title":"Case report: Subcutaneous Mycobacterium haemophilum infection in an immunocompetent patient after lipolysis injections","volume":"10","author":"Ni","year":"2023","journal-title":"Front Med [Lausanne]"},{"key":"R10-20260707","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1086\/321894","article-title":"Mycobacterium haemophilum in immunocompromised patients","volume":"33","author":"Shah","year":"2001","journal-title":"Clin Infect Dis"},{"key":"R11-20260707","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1111\/j.1365-2133.2012.11164.x","article-title":"Cutaneous Mycobacterium haemophilum infection in a patient receiving infliximab for psoriasis","volume":"168","author":"Aslam","year":"2013","journal-title":"Br J Dermatol"},{"key":"R12-20260707","first-page":"1291","article-title":"Mycobacterium haemophilum infection with cutaneous involvement: Two case reports and an updated literature review: Mycobacterium haemophilum skin infection","volume":"21","author":"Yasen","year":"2023","journal-title":"J Dtsch Dermatol Ges"},{"key":"R13-20260707","first-page":"793127","article-title":"Mycobacterium haemophilum masquerading as leprosy in a renal transplant patient","volume":"2013","author":"Copeland","year":"2013","journal-title":"Case Rep Dermatol Med"},{"key":"R14-20260707","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.jctube.2017.06.002","article-title":"Fifteen-year clinical experience with Mycobacterium haemophilum at the mayo clinic: A case series","volume":"8","author":"Tyner","year":"2017","journal-title":"J Clin Tuberc Other Mycobact Dis"},{"key":"R15-20260707","first-page":"e00561","article-title":"The brief case: Disseminated Mycobacterium haemophilum infection in a kidney transplant recipient","volume":"56","author":"Jacobs","year":"2018","journal-title":"J Clin Microbiol"}],"container-title":["The International Journal of Mycobacteriology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.4103\/ijmy.ijmy_73_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T13:01:20Z","timestamp":1783429280000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.4103\/ijmy.ijmy_73_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ijmy.ijmy_73_26","relation":{},"ISSN":["2212-5531","2212-554X"],"issn-type":[{"value":"2212-5531","type":"print"},{"value":"2212-554X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2026-02-17","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-20","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}