ATYPICAL MYCOBACTERIOSIS IN THE PRESENCE OF IMMUNOSUPPRESSION

We report on a 50-year-old patient with bluish swellings on the forearms and hands. These symptoms were accompanied by arthralgia. The patient treated himself with about 120 mg methylprednisolone daily, which initially resulted in only slight improvement. Microbiological investigations from cutaneous abscesses demonstrated an atypical mycobacterium (Mycobacterium chelonae). Occurrence of these bacteria is ubiquitous. In immunodeficient states infections are possible, which may be followed by dissemination of the mycobacteria in traumatic skin lesions. In the patient under discussion, dissemination was probably enhanced by the misuse of steroids. Despite chemotherapy, the patient died, perhaps as a consequence of dissemination.