Nichttuberkulöse Mykobakteriose als seltene Ursache chronischer Wunden

Wir berichten über einen 77-jährigen Patienten mit seit 8 Monaten progredienten Wunden am rechten Unterschenkel. Die histopathologische Untersuchung zeigte eine teils suppurative und teils granulomatöse Entzündung mit Nachweis von Mykobakterien, welche mit dem Nachweis von Mycobakterium chelonae/immunogenum mittels Nukleinsäureamplifikationstechnik im Referenzlabor als nichttuberkulöse Mykobakteriose (NTM) bestätigt wurde.

Abstract

We report on a 77-year-old patient with wounds on the right lower leg that had been progressive for eight months. The histopathological examination showed a partly suppurative and partly granulomatous inflammation with evidence of mycobacteria, which was confirmed as nontuberculous mycobacteriosis (NTM) by the detection of Mycobacterium chelonae/immunogenum using the nucleic acid amplification technique in the reference laboratory. The initiation of combined antibiotic therapy clarithromycin 500mg 1–0-1–0 p.o. and moxifloxacin 400mg 1–0-0–0 p.o. over 12 months led to a rapid response to therapy and ultimately to complete healing. This case underlines the relevance of considering NTM and other infections as a rare differential diagnosis in patients with chronic wounds. In addition to the presence of immunosuppression, unilateral and/or sporotrichoid distribution may be additional clues. As the detection of non-tuberculous mycobacteria is not always directly successful, repeated diagnostics and close collaboration with histopathology and microbiology laboratories is often necessary.

Schlüsselwörter

kutane nicht-tuberkulöse Mykobakteriose - Mykobakterium chelonae - Chronische Wunden

Keywords

cutaneous nontuberculous mycobacterial infection - mycobacterium chelonae - chronic wounds

Publication History

Received: 24 February 2025

Accepted after revision: 14 April 2025

Article published online:
04 June 2025

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