Disseminated cutaneous Mycobacterium chelonae infection.

Over the last two decades, a rising proportion of mycobacterial infections have been caused by nontuberculous species such as Mycobacterium chelonae.1-3 Belonging to the M. fortuitum complex,4 M. chelonae is an acidfast bacillus (AFB) that grows rapidly compared with the more common M. tuberculosis. Disseminated cutaneous manifestations are the most common presentations and occur in patients who are immunosuppressed by malignancy, corticosteroid therapy, or the various immunomodulating drugs used in organ transplantation.5 After an indolent course, the extremities are usually involved with several to hundreds of nodules, abscesses, and/or ulcers that are erythematous or indurated.5-7 We present the case of an elderly woman with a long-standing M. chelonae infection and a history of protracted corticosteroid therapy (longer than 6 months). The basis of diagnosis and current treatment modalities are reviewed.