Delayed Nontuberculous Mycobacterium Manifestation 1 Year after a Dog Bite on the Hand

Abstract

Nontuberculous mycobacteria infection can show various clinical manifestations as over 190 different species of nontuberculous mycobacteria have been identified. Among them, skin and soft tissue infections are commonly related with invasive procedures or trauma. The typical incubation period of rapidly growing mycobacteria is 3 to 6 weeks, whereas slowly growing mycobacteria takes 32 to 265 days of incubation. There have been a few cases of nontuberculous mycobacterium skin and soft tissue infections associated with animal bites, but none of them, not even mycobacteria with slow growth, had incubated for more than a year from the initial trauma. We present our case of delayed manifestation of nontuberculous mycobacterium skin and soft tissue infections at a year after receiving a dog bite on the hand. This case serves as a reminder that patients with delayed onset of local inflammation and granulation tissue on the hand must be reviewed for history of any previous trauma at the wound site and evaluated for the possibility of concealed nontuberculous mycobacterium infection.