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 500 mg 1–0–1–0 p.o. and moxifloxacin 400 mg 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.

Publication History

Article published online:
19 February 2026

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