Nontuberculous mycobacteria (NTM) are important pathogens for cutaneous infections related to contaminated environments and invasive procedures.
A 43-year-old woman presented with swelling of the forehead. Ten years ago, she underwent augmentation rhinoplasty using silicone implant. In response to the swelling, an incision was made, pus-like discharge was drained, and the nasal silicone implant was removed. Although routine culture and NTM culture showed negative results, NTM polymerase chain reaction detected NTM infection. After continued clarithromycin medication for 3 months, the patient recovered without recurrence of infection.
Mycobacteria are rarely detected with routine bacterial culture and are often resistant to empiric antibacterial agents. Therefore, the possibility of NTM infection should always be included in differential diagnosis, when evaluating skin lesions, regardless of the immune status of the patient.