Skin granulomas due to Mycobacterium gordonae

Area of Science:

• Dermatology
• Infectious Diseases
• Microbiology

Background:

• Mycobacterial infections can present with diverse cutaneous manifestations.
• Zoonotic transmission of mycobacteria, though rare, is a possibility in endemic areas.

Observation:

• A 38-year-old woman developed ulcerated nodules on her hand post-rat bite in Belgium.
• Clinical presentation mimicked mycobacterial granulomas, with histopathology confirming infection.
• Acid-fast bacilli were identified, leading to the isolation of Mycobacterium gordonae.

Findings:

• The identified Mycobacterium gordonae strain caused a localized skin infection.
• The patient's condition showed a significant positive response to rifampicin therapy.

Implications:

• This case highlights Mycobacterium gordonae as a potential pathogen in atypical skin infections following animal bites.
• Early diagnosis and appropriate antibiotic treatment, such as rifampicin, are crucial for managing such rare mycobacterial infections.
• Environmental exposure (collecting frogs in a pond) may have played a role in the initial transmission.