Abstract
While atypical mycobacterial infection caused by Mycobacterium fortuitum (M. fortuitum) in Japan is occasionally reported in the dermatological field, it is rarely observed in daily clinical practice of otolaryngology. Here we describe a case of subcutaneous abscess of the neck. The patient was a 50-year-old man. He was diagnosed with a subcutaneous abscess of the left neck of unknown etiology in January 1995 in the Otolaryngological Department of Showa University Hospital. The culture of aspirated fluid from the subcutaneous abscess detected acid-fast bacteria, suggesting tuberculous lymphadenitis. Combination therapy with INH and RFP was ineffective. Since M. f ortuitum, an atypical acid-fast bacteria, was identified, the patient received treatment with 300mg/day of LVFX, a new quinolone antimicrobial agent, for 6 months. In addition to this therapy, regional incision and drainage improved the symptom moderately. Further treatment with 300mg/day of oral LVFX for an additional 6 months provided no improvement. Thereafter, The subcutaneous abscess was cicatrized, followed by 2-month oral administration of 300m/dav of SPFX.
