Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
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Case Report

Volume 13, Number 2, February 2022, pages 61-65

Mycobacterium szulgai: A Rare Cause of Non-Tuberculous Mycobacteria Disseminated Infection


Figure 1.
Figure 1. Cutaneous manifestations. (a) Erythematous nodules on the left lower limb. (b) Violaceous plaque in the left gluteal region.
Figure 2.
Figure 2. Enlarged mediastinal lymph node with a heterogeneous internal texture (arrow) on the computed tomography (CT) chest scan.
Figure 3.
Figure 3. Two noncaseating epithelioid granulomas with tightly packed epithelioid cells and overlapped lymphocytes. Respiratory epithelium with normal morphology. (hematoxylin and eosin staining, × 100 magnification).
Figure 4.
Figure 4. Skin biopsy showing neutrophilic infiltrate and focal granulomas (a) composed of histiocytes, lymphocytes and plasmacytes (b).


Table 1. Blood Tests Results
Blood testResult (normal range)
Ig: immunoglobulin; C: complement.
Erythrocyte sedimentation rate63 mm/h (1 - 20 mm/h)
Hemoglobin11.6 g/dL (12 - 16 g/dL)
Mean corpuscular volume78 fL (80 - 100 fL)
C-reactive protein12 mg/dL (0.5 - 1 mg/dL)
Lactate dehydrogenase332 U/L (< 247 U/L)
Alkaline phosphatase316 U/L (30 - 120 U/L)
Gamma-glutamyl transferase119 U/L (< 31 U/L)
Serum angiotensin converting enzyme26 U/L (8 - 52U/L)
Serum protein immunoelectrophoresisNormal
Serum immunofixationNormal
Ratio of kappa and lambda light chainsNormal
IgM, IgG, IgA, IgENormal
C3, C4Normal
Antinuclear antibodiesPositive (1:640, dense fine speckled pattern)
Anti-double stranded DNA0.5 IU/mL (> 10 IU/mL)
Extractable nuclear antigens antibodiesNegative


Table 2. Serologies Results
Ig: immunoglobulin; EBNA: Epstein-Barr nuclear antigen; HbsAg: hepatitis B surface antigen; HbsAb: hepatitis B surface antibody; HbcAb: hepatitis B core antibody; Ag: antigen; Ab: antibody.
CytomegalovirusNegative (IgM and IgG)
Herpes simplex virus 1 and 2Negative (IgM and IgG)
Epstein Barr virusNegative (IgM, IgG and EBNA)
Hepatitis B virusNegative (HBsAg, HBsAb and HBcAb)
Hepatitis C virusNegative (IgM and IgG)
Hepatitis A virusNegative (IgM and IgG)
Human immunodeficiency virusNegative (Ag/Ab)
Treponema pallidumNegative (IgM and IgG)
Toxoplasma gondiiNegative (IgM and IgG)
Rickettsia conoriiNegative (IgM and IgG)
Coxiella burnetiiNegative (IgM and IgG)
Borrelia burgdorferiNegative (IgM and IgG)
Brucella speciesNegative (IgM and IgG)
Bartonella henselaeNegative (IgM and IgG)