Diagnostic odyssey of a cutaneous mycobacteriosis rare in central Europe.
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.
Fischer
Tobias  W
T
Department of Dermatology and Allergology, Friedrich Schiller University, Jena, Germany.
Assefa
Sentayehu
S
Bauer
Heike I
HI
Graefe
Tim
T
Scholz
Matthias
M
Pfister
Wolfgang
W
Barta
Ute
U
Wollina
Uwe
U
Elsner
Peter
P
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
D000900:Anti-Bacterial Agents; D017291:Clarithromycin