Mycobacterium fortuitism is a non-tuberculoses mycobacterium and is rapidly growing. It is found in the environment including water and dirt throughout the world. Applicability to podiatry is that patients with skin disease may develop a non-healing but non-spreading wound or skin ulcer. Local wound care for these lesions is treatment of choice. Most of these lesions will heal through conservative care without the need for surgery. Prolonged antibiotic therapy is generally required. Most infections can be treated with oral antibiotic therapy, but in serious cases IV antibiotics may be warranted. Two antibiotics should generally be used in treatment. Obtain culture and sensitivities to guide antibiotic treatment.
A variety of antibiotics are effective in treatment including clarithromycin, amikacin, cefoxitin, imipenem, cipro, levofloxacin, doxycycline, trimethoprim-sulfamethoxazole, linezolid, and tigecycline. Treatment length is not standardized and can last for months.