Cutaneuous Mycobacterium chelonae Infection in a Kidney Transplant Recipient With Long-Term Immunosupression and Eculizumab Therapy

Diana Sukackiene^1*Deimante Satkauskaite¹Ugne Sleivyte¹Arturas Vinikovas¹Gintare Ulianskaite¹Justinas Pamedys²Tadas Raudonis¹(EE) Marius Miglinas¹

• ¹Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
• ²Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania

Mycobacterium chelonae is a rapidly growing nontuberculous mycobacterium (NTM) that causes skin and soft tissue infections, particularly in immunocompromised patients. We present a case of a 51-year-old woman receiving eculizumab therapy after kidney transplantation, who developed painful nodules and ulcers on the lower leg. Standard laboratory and imaging findings were unremarkable. Initial cultures were negative, but biopsy and subsequent wound cultures identified M. chelonae. Repeat testing confirmed the pathogen. The patient was successfully treated with a 12-month course of combination antibiotics, including clarithromycin, linezolid and doxycycline, along with intralesional gentamicin. A follow-up biopsy showed dermal fibrosis without microorganisms. This case highlights the diagnostic challenges of M. chelonae in transplant recipients and emphasizes the importance of molecular diagnostics and tailored therapy. To our knowledge, this is the first reported case of M. chelonae infection in a kidney transplant recipient receiving eculizumab as part of her post-transplant management.