We report a case of Mycobacterium smegmatis granuloma in the soft tissues of the first web space of the left hand in a 67-year-old Caucasian woman. She was in good systematic health; there was no recollection of trauma to the hand. A combined regime of prolonged antibiotic therapy and surgical debridement was necessary to ultimately eradicate the infection. The natural history, microbiology, and treatment of this rare hand infection are discussed.
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