Introduction:

Immune deficiency is the main risk factor for the atypical mycobacteriosis infection and its progression. Erythematous, infiltrative skin lesions with nonspecific symptoms impede the diagnosis of atypical mycobacterium cutaneous infection, which is commonly mediated by Mycobacterium marinum.

Objective:

We present the case of a 76-year-old woman with infiltrative ulcerative skin lesions on her left upper extremity.

Case report:

The diagnosis of mycobacteriosis included histological tissue findings as well as a microbiological verification. Immune deficiency was excluded. Mycobacterium chelonae was detected in the infected tissue with the polymerase chain reaction method. Targeted antibiotic therapy was implemented, initially with clarithromycin, followed by intravenous linezolid, leading finally to complete cure.

Conclusions:

The diagnosis of atypical mycobacteriosis is based on the complex and time-consuming microbiological examination including molecular diagnostics and culture. It is essential to administer targeted antibiotic therapy based on the antibiogram, due to possible broad antibiotic resistance of non-tuberculous mycobacterioses.