A case of cutaneous Mycobacterium chelonae infection of the right leg

A 71-year-old male had suffered from painful dark red nodules on his right leg for three months. He had chronic hypersensitivity pneumonitis treated with prednisolone (10mg/day) and diabetes mellitus caused by steroids. He sometimes cultivated the land on the hill for fun. Culture of a skin biopsy specimen from the nodule yielded white colonies after five days, and DNA-DNA hybridization revealed that these were Mycobacterium chelonae. The patient was treated with levofloxacin 300mg/day and clarithromycin 400mg/day, which successfully improved his conditions. Recently, clarithromycin has become recognized as an effective agent in the treatment of cutaneous M. chelonae, and it was also effective in our case. Further discussions are needed to decide when to stop medication without recurrence.