Acid-fast bacilli staining for nonhealing ulcers: a case report of cutaneous Mycobacterium chelonae infection

Document Type

Article

Publication Date

7-1-2025

Publication Title

Wounds

Abstract

BACKGROUND: Cutaneous infections due to nontuberculous mycobacteria (NTM) are rare, and they can be challenging to treat, often requiring prolonged therapy with multiple antibiotics. Although recent literature challenges the idea of routine acid-fast bacilli (AFB) testing in diabetic foot infections, this report presents a case of Mycobacterium chelonae (M chelonae) infection in a patient with nonhealing ulceration.

CASE REPORT: A 64-year-old female with no history of immunocompromise and no recent surgical history presented with a rapidly growing ulceration despite appropriate antibiotic therapy based on routine aerobic culture results. After AFB cultures were obtained, she was found to have NTM infection with M chelonae, and the ulceration was healed without recurrence after treatment for 4 months with linezolid and clarithromycin.

CONCLUSION: This case highlights the potential inoculation of M chelonae, even in immunocompetent patients without known inoculation injury, and it highlights the value of AFB cultures in patients who do not progress with standard wound care therapies and routine aerobic cultures.

Medical Subject Headings

Humans; Female; Mycobacterium Infections, Nontuberculous; Mycobacterium chelonae; Middle Aged; Anti-Bacterial Agents; Clarithromycin; Treatment Outcome; Wound Healing; Skin Diseases, Bacterial; Linezolid; Staining and Labeling

PubMed ID

40801883

Volume

37

Issue

7

First Page

264

Last Page

268

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