A 56-year-old female presented with a persistent, non-healing ulcer on her left forearm, initially misdiagnosed and treated unsuccessfully for various conditions over several months in rural Mississippi. Her symptoms included a painful, erythematous, and indurated lesion that progressed despite multiple antibiotic courses. Diagnostic challenges were overcome by biopsy and subsequent culture, which ultimately identified Mycobacterium chelonae as the causative agent. This case highlights the critical need for early consideration of atypical mycobacterial infections in non-healing skin lesions, especially in regions with limited advanced diagnostic resources, to prevent prolonged morbidity and ensure appropriate antimicrobial therapy.
Key note: A high index of suspicion for atypical mycobacterial infections is crucial for timely diagnosis and effective treatment of chronic, non-healing skin lesions.