Surgical site infection with Mycobacterium fortuitum following Mohs micrographic surgery in an immunocompromised patient and review

Mycobacterium fortuitum (M. fortuitum) is a rare infection typically occurring in immunocompromised patients and in healthcare settings, primarily after surgery or exposure to contaminated medical equipment or tap water. A few cases have been reported following cutaneous procedures, including acupuncture, mesotherapy, and tattooing, although no report, to our knowledge, has been described after Mohs micrographic surgery (MMS). Treatment typically requires at least 2 oral antibiotics for several months owing to the persistent nature of the infection. We present a patient who had previously undergone MMS with bilobed flap and developed infection with M. fortuitum, treated with moxifloxacin 400 mg daily and trimethoprim-sulfamethoxazole 400 mg/80 mg daily.