Around 50 mycobacteria species cause human disease. Immunosuppressive states
predispose to non-tuberculous mycobaterium infection, such as Mycobacterium chelonae:
AFB, non-tuberculous, fast growth of low virulence and uncommon as a human pathogen.
It may compromise the skin and soft tissues, lungs, lymph nodes and there is also a
disseminated presentation. The diagnosis involves AFB identification and culture on
Agar and Lowenstein-Jensen medium base. A 41-year-old female with MCTD (LES
predominance) is reported, presenting painless nodules in the right forearm. She
denied local trauma. Immunosuppressed with prednisone and cyclophosphamide for 24
months. Lesion biopsy has demonstrated positive bacilloscopy (Ziehl-Neelsen stain)
and M.chelonae in culture (Lowenstein-Jensen medium base), therefore clarithromycin
treatment has been started (best therapy choice in the literature).
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