TABLE 4.

Risk factors for acquiring major nontuberculous mycobacterial infections of the skin and soft tissues and medical and surgical recommendation

Mycobacterial species	Risk factors for cutaneous disease	Therapy
M. fortuitum	Dermal piercing, tattoos, mesotherapy, acupuncture, intravascular devices (e.g., central venous catheters), peritoneal dialysis catheters	Combination of macrolide, fluoroquinolones, doxycycline, trimethoprim-sulfamethoxazole; surgical excision may be indicated
M. abscessus complex	Cosmetic surgery, postsurgical infections, acupuncture, mesotherapy, pedicure sessions	Combination of macrolide (azithromycin or clarithromycin), cefoxitin, imipenem, amikacin; surgical excision and/or debridement need to be considered for severe deep tissue involvement
M. chelonae	Tattoos, mesotherapy, acupuncture	Combination of macrolide (azithromycin or clarithromycin), cefoxitin, imipenem, fluoroquinolones, amikacin; surgical excision may be indicated
M. haemophilum	Cosmetic procedures, permanent makeup, HIV infection/AIDS, anti-TNF-α blockers, freshwater or salt water injuries	Combination of macrolide (clarithromycin), fluoroquinolones, rifamycin; surgical excision may be indicated, similarly to infections caused by M. abscessus complex
M. marinum	Freshwater or salt water injuries associated with fishing injuries, coral trauma, and other related injuries	Combination of clarithromycin and ethambutol or trimethoprim-sulfamethoxazole and rifampin; alternative drugs include doxycycline or minocycline
M. kansasii	HIV infection/AIDS, renal transplant, chronic pulmonary diseases	Combination of isoniazid, rifampin, ethambutol; clarithromycin may be used instead of isoniazid; linezolid is an alternative drug