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Mycobacterium marinum
From WikEM
Contents
Background
- Atypical Mycobacterium species found in fresh or salt water (cold or warm)
- Bacteria that causes "fish tank Granuloma"
- Can infect both immunocompetent and immunocompromised hosts
- M. marinum is generally not found in chlorinated swimming pools[1]
Risk Factors
- Aquarium workers and enthusiasts
- Swimming
- Handling of contaminated water
Clinical Features
Fish tank granuloma. [2]
- Solitary to multiple superficial red nodules or plaques in exposed areas
- Lesions on the hands and fingers if works with aquariums, or the knees and elbows in swimmers
- Ascending lymphangitis that resembles Sporotrichosis
Differential Diagnosis
Skin and Soft Tissue Infection
- Cellulitis
- Erysipelas
- Lymphangitis
- Abscess
- Necrotizing soft tissue infections
- Mycobacterium marinum
Look-A-Likes
Evaluation
- Clinical diagnosis in ED
- Can be aided by histopathology
- If there is an affected joint it is important to evaluate for a septic arthritis
- If there are draining wounds consider imaging and evaluate for osteomyelitis
Management
- Long-term antibiotic therapy (2-18 weeks)
- Monotherapy with doxycycline, clarithromycin, bactrim, or minocycline[3][4]
- Secondary to drug high levels of drug resistance, may require dual drug therapy
- Warm compresses (bacterium is heat-sensitive)
Disposition
- Unless the patient has evidence of sepsis, severe pain, or has other severe complicating medical problems, outpatient treatment is acceptable.
Clinical Course
- M marinum infection may result in non-healing ulcers or a septic arthritis.
- Aggressive or long standing . marinum infection may cause severe osteomyelitis requiring surgical debreedment
See Also
External Links
References
- ↑ Slany M et al. Mycobacterium marinum infections in humans and tracing of its possible environmental sources. Can J Microbiol. 2012. 58(1): 39-44
- ↑ Ryan, J and Bryant G. "Fish tank granuloma - a frequently misdiagnosed infection of the upper limb." J Accid Emerg Med. 1997 Nov; 14(6): 398–400.
- ↑ Petrini, B; "Mycobacterium Marinum: ubiquitous Agent of Waterborne Granulomatous Skin Infections." European Journal of Clinical Microbiology and Infectious Diseases. October 2006, Volume 25, Issue 10, pp 609-613
- ↑ Rallis, E; Koumantaki-Mathioudaki, E; "Treatment of Mycobacterium Marinum Cutaneous Infections." Expert Opinion on Pharmacotherapy. Volume 8, Issue 17, 2007
