A rare catch in a nonhealing wound

Introduction. Mycobacterium smegmatis is a common microbe found in soil, dust, and water that rarely causes infections in humans. Case Report. A 45-year-old man with a past medical history of hypertension presented with a nonhealing surgical wound in his anterior chest wall, measuring 0.5 cm x 0.5 cm x 0.3 cm with minimal serosanguinous drainage, that had been present for more than 1 year. Wound swab showed M smegmatis. He required a 3-month course of antibiotic treatment and advanced wound care that included packing the sinus wounds with silver-alginate dressings for the first 2 weeks followed by iodoform packing; once the infection and drainage had improved after 2 months of treatment, packing was changed to a collagen dressing. He responded well to treatment, and the ulcers completely closed at the end of his 3-month course. Conclusions. This case illustrates the importance of considering atypical microbial infections in the workup for chronic nonhealing wounds.