Mycobacteria fortuitum and chelonae are a group of Rapidly Growing Mycobacteria (RGM) that can cause skin infections, most commonly in immunocompromised patients. RGM can also infect immunocompetent patients, but the disease is usually localized. Immunocompetent patients infected by RGM usually had a predisposing condition leading to the skin infection. We present a case of an immunocompetent patient with no predisposing factors, who presented with a chronic lesion on his neck that disseminated to his axilla. Culture and species identification from the skin biopsy revealed Mycobacterium fortuitum-chelonae complex. The patient was treated with a combination of surgery and multi-drug therapy. This case report highlights the rarity of cutaneous RGM infections encountered in ENT setting and the diagnostic dilemma due to the non-typical characteristics of skin lesion in RGM infections.

Complete cricotracheal separation, which is the most severe type of laryngeal trauma, is an uncommonly seen injury that clinicians have limited experience in managing. However, it is potentially fatal. Due to limited exposure to this condition, mismanagement can occur, which may further aggravate the patient’s condition. The most crucial part of managing this injury is to establish a secure airway. Tracheostomy under local anesthesia is the preferred method of airway stabilization, in order to avoid further injuries to the airway caused by endotracheal intubation. Here, we discuss the management of complete cricotracheal separation based on a case experienced in the east coast region of Malaysia, where this type of injury is rarely encountered.