Recurrent pocket infection due to Mycobacterium chelonae at the site of an explanted cardiac implantable electrical device in proximity to a long-standing tattoo.

KEY TEACHING POINTS We present the first reported case of infection of a cardiac implantable electrical device with a nontuberculous mycobacterium. We also discuss the importance of conducting a thorough microbiological investigation to correctly identify the causative organism in cases in which initial investigations have negative results yet symptoms persist. In addition, the issues surrounding the increasing prevalence of Mycobacterium chelonae and its possible relationship to contaminated tattoo ink are discussed in the context of this case.