Acid-fast bacteria can be implicated in skin and soft tissue infections.
Diagnostic identification can be challenging or not feasible by routine
laboratory techniques, especially if there is no access to the Matrix Assisted
Laser Desorption Ionization Time of Flight Mass Spectrometry (MALDI-TOF MS)
technology. Here, we present two cases of skin and soft tissue infections caused
by two different acid-fast bacteria,
Nocardia brasiliensis
and
Mycobacterium marinum
. They both grew on Löwenstein–Jensen
medium, Sabouraud agar medium and blood agar medium. Both bacteria appeared
acid-fast by Ziehl–Neelsen stain and Gram-positive by Gram stain. The
identification was performed by MALDI-TOF MS and gene analysis.
N.
brasiliensis
and nontuberculous mycobacterium
M.
marinum
represent rare pathogens that cause severe skin and soft
tissue infections. Failure to identify the causative agent and subsequent
inappropriate or inadequate treatment may lead to severe complications or even
disseminated disease, especially in immunocompromised individuals.