A 38-year-old woman presented with small, ulcerated, red or bluish nodules on the right hand, clinically resembling mycobacterial granulomas; these appeared a few months after a bite by a rat, while the patient was collecting frogs in a pond in the Belgian Ardennes. The histopathologic picture was compatible with a diagnosis of mycobacterial infection and rare acid-fast bacilli could be found. Repeated bacteriologic investigations were performed and these led to the identification of a strain displaying characteristics of Mycobacterium gordonae. The skin condition responded well to rifampicin (300 mg/day) within 6 months.
Gengoux, P., Portaels, F., Lachapelle, J.-M., Minnikin, D. E., Tennstedt, D., & Tamigneau, P. (1987). Skin granulomas due to Mycobacterium gordonae. International Journal of Dermatology, 26(3), 181-184. https://doi.org/10.1111/j.1365-4362.1987.tb00888.x (Original work published 1987)