Abstract
Atypical mycobacterium infections are an uncommon cause of cutaneous infection, and they are especially rare infections of the facial region. Immunocompromised patients, such as transplant patients, are at higher risk for infections of this nature with concurrent hematogenous spread to other organ systems. We report a patient with a previous heart transplant who developed an atypical mycobacterium infection of the skin with possible dissemination to the lung. The case outlines the difficulty in diagnosing this condition along with the challenges of prescribing an effective drug regimen to treat this infection. Azithromycin, minocycline, rifabutin, and high-dose ethambutol were effective in clearing the skin and lung lesions.