Atypical Mycobacterium infection with dermatological manifestation in a renal transplant recipient

In April 1997, a 58-year-old renal transplant recipient presented with absc ess-like nodules in his left calf and on his right foot. Furuncular disease was suspected and the patient was treated with flucloxacillin. However, th e lesions increased in size and became ulcerative. In the following 3 month s, cultures of punctuated material, blood, and urine remained negative and gram stains did not reveal micro-organisms. In June 1997, acid-fast stains were positive. A diagnosis of a nontuberculous mycobacterium (NTM) infectio n was made and empirical antimycobacterial therapy was started. The combina tion of relatively minor symptoms with enlarged purulent lesions, causing s evere morbidity, raises the possibility of NTM infection in the immunocompr omised patient.