Mycobacterium marinum: nodular hand lesions after a fishing expedition

BMJ Case Rep. 2020 Dec 13;13(12):e238835. doi: 10.1136/bcr-2020-238835.

Abstract

Mycobacterium marinum is a slow-growing, acid-fast bacillus in the category of non-tuberculous mycobacteria which most commonly cause skin and soft tissue infections in patients, particularly those with aquatic exposure. Classically, M. marinum skin and soft tissue infections clinically manifest with formation of nodular or sporotrichoid extremity lesions, or deeper space infections such as tenosynovitis and osteomyelitis. Disseminated disease may occur in immunocompromised hosts. M. marinum is a slow-growing organism that is challenging to culture, as it typically requires 5-14 days (yet may take up to several weeks) with low temperatures of approximately 30°C to yield growth. In terms of treatment, further data are needed to elucidate the optimal regimen and duration for M. marinum infections. Combination therapy with clarithromycin and ethambutol is recommended for treatment of skin and soft tissue infections, with addition of rifampicin for deeper space infections. Surgery may be needed in addition to medical management.

Keywords: dermatology; infectious diseases.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Finger Injuries / complications*
  • Humans
  • Leisure Activities
  • Male
  • Middle Aged
  • Mycobacterium Infections, Nontuberculous / diagnosis*
  • Mycobacterium Infections, Nontuberculous / drug therapy
  • Mycobacterium Infections, Nontuberculous / pathology
  • Mycobacterium marinum / isolation & purification*
  • Radiography
  • Skin Diseases, Bacterial / diagnosis*
  • Skin Diseases, Bacterial / drug therapy
  • Skin Diseases, Bacterial / etiology
  • Skin Diseases, Bacterial / pathology
  • Soft Tissue Infections / diagnosis*
  • Soft Tissue Infections / drug therapy
  • Soft Tissue Infections / etiology
  • Soft Tissue Infections / pathology
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents