Primary cutaneous infection with Bacillus megaterium mimicking cutaneous anthrax

Abstract

To the Editor: A 25-year-old immunocompetent woman presented with a progressively worsening lesion on her left ankle. Two weeks earlier, while hiking in the local mountains of Napa Valley, CA, she first noticed an asymptomatic, black adherent crust on the lower aspect of her left leg. One week later the area developed a pruritic plaque with a central bulla. Four days before her current presentation the blister fluid was cultured and she was treated with a topical corticosteroid. After 3 days there was no improvement and her left foot began to swell. She never experienced fever, chills, or other systemic symptoms.