Background: Non-tuberculous mycobacterial (NTM) infections have been drawing interest
recently because of their rising incidence not only in immunocompromised but also in immunocompetent
individuals. These are underdiagnosed in India, due to the lack of awareness and
a low index of suspicion. In regions endemic for tuberculosis (TB) such as India, presumptive
anti-tubercular treatment (ATT) is often prescribed. Non-response of NTM to the treatment may
be wrongly ascribed to multidrug-resistant tuberculosis. This emphasizes the need to correctly
identify them before initiating therapy.
Case Study: We describe the case of a young, healthy female patient who developed cervical
lymphadenitis and was given presumptive ATT. Microbiological examination of aspirate revealed
M. fortuitum. This not only rectified the course of treatment resulting in complete cure, but also
spared the patient from significant side effects of ATT. This case is an awakening call for clinicians
to avoid presumptive ATT.