Mycobacterium abscessus felon complicated with osteomyelitis: not an ordinary nail salon visit.

Abstract

Mycobacterium abscessus is an environmental organism that has been implicated in pulmonary and extrapulmonary infections. Cases of furunculosis have been described in patients who underwent footbaths in nail salons; however, no cases of severe soft tissue infections or osteomyelitis have been reported following manicures. Here, we present the case of a 50-year-old woman who developed a felon in right index finger one week after having a manicure. She underwent incision and drainage of affected area. Cultures from purulence grew Mycobacterium abscessus. Imaging revealed osteomyelitis of distal phalanx. She was successfully treated with a prolonged course of antibiotics that included imipenem, linezolid, tigecycline, and clarithromycin. We highlight the importance of recognizing this uncommon complication and advocate the use of combined antibiotic regimens for an adequate treatment of this infection.