低温培養を追加し診断に至った播種性皮膚<i>Mycobacterium chelonae</i>感染症の1例

Mycobacterium chelonae is a rapidly growing nontuberculous mycobacterium and rare cause of cutaneous infection in both immunocompromised immunocompetent patients. The skin lesions are non-specific nature, so that the remains underdiagnosed diagnosis often delayed. Herein, we report case an 83-year-old woman with 6-month history persistent lesions. were previously misdiagnosed treated as herpes zoster, even bullous pemphigoid, for which she received prednisone. Ziehl-Neelsen staining biopsy specimens from subcutaneous nodules on right forearm dorsum left foot revealed acid-fast bacilli. Culture blood agar medium under low-temperature conditions yielded colonies after 6 days. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry allowed identification M. chelonae; results consistent 16S rRNA gene sequencing analysis. Therefore, made disseminated initiated patient combined clarithromycin, moxifloxacin, amikacin therapy. findings this indicate clinicians should consider mycobacterium-related infections patients intractable To obtain proper microbiological diagnosis, good collaboration between clinical laboratory technicians necessary, collection appropriate use stains culture conditions, bearing mind suspected microorganisms.