title: Diagnostic odyssey of a cutaneous mycobacteriosis rare in central Europe.
abstract: Cutaneous infection with Mycobacterium chelonae is an uncommon disease, although this atypical mycobacterium is an acid-fast bacillus ubiquitous in the environment. It is often misdiagnosed and treated as a fungal or common bacterial infection. We report a case of disseminated atypical mycobacterial skin infection of a 72-year-old woman who was treated with different topical and systemic antimycotic and antibiotic drugs over a period of 5 months without remarkable improvement. Eventually, repeated tissue cultures on special medium and performance of PCR led to the diagnosis of M. chelonae infection. The patient was treated successfully with oral clarithromycin within 8 weeks. In case of abscessing cutaneous infection, M. chelonae should be considered in the differential diagnosis of prolonged disease when common antibiotics are not effective after 2-4 weeks of treatment.
authors.affiliation: Department of Dermatology and Allergology, Friedrich Schiller University, Jena, Germany.
authors.forename: Tobias  W
authors.initials: T
authors.lastname: Fischer
authors.forename: Sentayehu
authors.initials: S
authors.lastname: Assefa
authors.forename: Heike I
authors.initials: HI
authors.lastname: Bauer
authors.forename: Tim
authors.initials: T
authors.lastname: Graefe
authors.forename: Matthias
authors.initials: M
authors.lastname: Scholz
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Pfister
authors.forename: Ute
authors.initials: U
authors.lastname: Barta
authors.forename: Uwe
authors.initials: U
authors.lastname: Wollina
authors.forename: Peter
authors.initials: P
authors.lastname: Elsner
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001132:Arm; D017291:Clarithromycin / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D005060:Europe; D005260:Female; D006801:Humans; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D016926:Mycobacterium chelonae / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D012874:Skin Diseases, Infectious / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D017291:Clarithromycin