Infectious Diseases Question 70

A 29-year-old woman is evaluated for a 5-day history of nodules over her lower extremities. She reports that she regularly visits a local spa that uses whirlpool footbaths during her pedicure procedures; she always shaves her legs with a razor before these visits. Medical history is unremarkable, and she takes no medications.

On physical examination, temperature is 37.0 °C (98.6 °F), blood pressure is 120/70 mm Hg, pulse rate is 70/min, and respiration rate is 14/min. BMI is 22. No inguinal lymphadenopathy is apparent. Several mildly tender, erythematous nodules and papules are noted over the distal lower extremities bilaterally; several lesions appear furuncular with associated ulceration. The remainder of the examination is normal.

Punch biopsy of a lesion reveals a necrotizing granulomatous dermatitis, and tissue culture grows a mycobacterial species within 4 days.

Which of the following is the most likely cause of infection?

A Mycobacterium fortuitum

B Mycobacterium gordonae

C Mycobacterium kansasii

D Mycobacterium marinum

Choose an Answer Above

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