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Proteus mirabilis , the most widespread species of all  Proteus  spp. bacteria, is proven to be one of the most universal pathogens in chronic wounds. In this case, a woman in her 40s consulted a physician about an asymptomatic ulceration with a stalactite appearance at the distal end of the index finger after she was exposed to a needle when vaccinating chickens. The patient did not response to ceftazidime. Physical examination revealed a well-demarcated violescent ulceration with a stalactite appearance at the distal end of the index finger. A biopsy of the lesion showed dense infiltration of multinucleated giant cells, histiocytes, and lymphocytes in the dermis. The result of metagenomics next-generation sequencing (NGS) showed 306 unique sequence reads of  P. mirabilis , covering 33.49% of the nucleotide sequences. The pathogen was identified as  P. mirabilis , which was resistant to ceftazidime. The patient was treated with ciprofloxacin hydrochloride and improved considerably. This case reported a distinctive cutaneous lesion of  P. mirabilis  on human infection and showed a successful use of NGS in  P. mirabilis .

Case Report: An Ulceration With a Stalactite Appearance on the Index Finger