Mycobacterium marinum infection from sea monkeys

A case of cutaneous Mycobacterium marinum infection acquired from Artemia nyos (sea monkeys) is presented. The infection was unresponsive to initial antimicrobial therapies. A biopsy of a lesion revealed granulomatous inflammation with cultures that subsequently grew M marinum. A three-month course of clarithromycin provided complete resolution.     

Mycobacterium marinum infection after infliximab therapy

A case of Mycobacterium Marinum infection of the nasal cavity is described. A 57 years old man was being on Infliximab for 2 years for severe psoriasis presented with five months history of epistaxis, nasal blockage and snoring. Local examination revealed bilateral nasal mass. The diagnosis of mycobacterial infection was suspected based upon the histopathological finding of granuloma in the biopsy specimen, and later confirmed by Mycobacterial culture. The patient was treated with 3 months therapy of Ethambutol and Rifampicin with good clinical response.The clinical presentation of the case is discussed with a review of the literature about current guidelines for prophylaxis and other preventive strategy for infection among patients receiving TNF antagonists.     

Mycobacterium marinum infection of the hand

Mycobacterium marinum is an atypical mycobacterium which may cause skin infections, tenosynovitis, arthritis, and osteomyelitis, especially in association with exposure to marine environments. We describe a 59‐year‐old chef with left wrist dorsal tenosynovitis and left third metacarpophalangeal synovitis due to M. marinum. Ultrasonography assisted in confirming the diagnosis of tenosynovitis and obtaining tissue for culture. In comparison to CT scan and MRI scan, ultrasonography has the advantage of being a cheaper imaging modality with no risk of radiation.     

Skin infection caused by Mycobacterium marinum

Mycobacterium (M.) marinum is a human opportunistic pathogen, capable of causing skin infections and possibly also affecting deeper tissues. The authors describe a case of skin infection caused by M. marinum in a female patient with an appropriate case history. They emphasize the need of close cooperation of the clinician with a microbiologist when establishing the diagnosis.     

Mycobacterium marinum infections

Mycobacterium marinum is a saprophytic mycobacteria capable of causing soft tissue infection in humans, usually acquired by inoculation. As with other mycobacterial infections, diagnosis may be difficult and recent developments in molecular biology are also being applied to atypical mycobacteria such as Mycobacterium marinum.     

Disseminated Mycobacterium marinum infection in a patient with diabetic nephropathy

A patient with diabetic nephropathy who presented with multiple tender subcutaneous nodules caused by Mycobacterium marinum infection is presented.     

Antigen-specific T-cell anergy in progressive Mycobacterium marinum infection in humans

The cellular immune responses of 12 patients with culture-proved Mycobacterium marinum infection involving deep tissues were studied. Of the 12 patients, 11 failed to respond to M. marinum antigens. All of the patients had, however, normal blastogenic responses to concanavalin A, phytohemagglutinin, pokeweed mitogen, and the antigens tetanus toxoid and Candida albicans. In contrast, 9 of 14 healthy fishermen responded to the M. marinum antigens with significant in-vitro blastogenesis. Infection of deep tissues with M. marinum is associated with antigen-specific T-cell anergy to M. marinum antigens.     

Nostril infection due to Mycobacterium marinum in an immunocompetent host

Mycobacterium marinum infection developed in the nostril of an immunocompetent host whose only risk factors were infrequent swimming and cleaning of a small fish bowl on a single occasion. The lesion relapsed after 2 surgical excisions but resolved slowly with a 9-month course of trimethoprim/sulfa therapy.     

Short course monotherapy with clarithromycin for localized Mycobacterium marinum skin infection

In vitro studies have shown that Mycobacterium marinum is usually susceptible to clarithromycin. However, there are limited published data on the clinical use of clarithromycin for the treatment of M marinum infections. This report describes a previously healthy 58-year-old man who developed a chronic soft tissue infection of his right hand caused by M marinum. He responded to four weeks' therapy with clarithromycin. Follow-up at six months showed no relapse. Our experience and review of the literature suggest that short course monotherapy with clarithromycin may be quite effective for uncomplicated soft issue infections caused by M marinum.     

Disseminated Mycobacterium marinum infection in a hematopoietic stem cell transplant recipient

Mycobacterium marinum is a photochromogenic mycobacterium that is ubiquitous in the aquatic environment. In the general population, exposure to aquaria is the most common cause of M. marinum infection. Known as "swimmer's granuloma" or "fish tank granuloma," M. marinum is an occupational hazard for aquarium cleaners and fishermen. There are several reports in the literature of M. marinum infection in immunocompromised hosts, including those with solid organ transplants, but none in patients who have received stem cell transplants (SCTs). To our knowledge, this is a first report of disseminated M. marinum infection in an SCT recipient who continued to develop new skin lesions even after months of targeted therapy. The implications are that elderly patients who receive T-cell-depleted SCTs may be at prolonged risk for pathogens dependent on cellular immunity, and the presentation of illness with such pathogens may be more severe and widely disseminated than might otherwise be expected.     

Disseminated cutaneous Mycobacterium marinum infection in a patient with non-Hodgkin's lymphoma

A 60-year-old woman with non-Hodgkin's lymphoma was admitted to the hospital because of extensive subcutaneous abscesses developing on all limbs. The patient had an aquarium and kept tropical fish as pets. After repeated investigations, the diagnosis of Mycobacterium marinum was established from skin biopsy by PCR and culture. Long-term therapy with several drugs regimens had only a limited efficacy and was accompanied by severe adverse reactions. This report highlights the therapeutic problems posed by disseminated cutaneous M. marinum infection in the immunosuppressed host. Received: July 3, 2001 · Revision accepted: August 19, 2002 Ruxandra Enzensberger (corresponding author)     

Complex pattern of Mycobacterium marinum gene expression during long-term granulomatous infection

During latent infection of humans with Mycobacterium tuberculosis, bacteria persist in the asymptomatic host within granulomas, organized collections of differentiated macrophages, and other immune cells. The mechanisms for persistence remain poorly understood, as is the metabolic and replicative state of the microbes within granulomas. We analyzed the gene expression profile of Mycobacterium marinum, the cause of fish and amphibian tuberculosis, during its persistence in granulomas. We identified genes expressed specifically when M. marinum persists within granulomas. These granuloma-activated genes were not activated in vitro in response to various conditions postulated to be operant in tuberculous granulomas, suggesting that their granuloma-specific activation was caused by complex conditions that could not be mimicked in vitro. In addition to the granuloma-activated genes, the bacteria resident in granulomas expressed a wide range of metabolic and synthetic genes that are expressed during logarithmic growth in laboratory medium. Our results suggest a dynamic host-pathogen interaction in the granuloma, where metabolically active bacteria are kept in check by the host immune system and where the products of granuloma-specific bacterial genes may thwart the host's attempt to completely eradicate the bacteria.     

A case of disseminated Mycobacterium marinum infection following systemic steroid therapy

We describe the dissemination of Mycobacterium marinum infection from the right middle finger to the whole extremity and two legs, with the involvement of tendons and joints, in a patient who was treated with a steroid when Mycobacterium marinum infection was not suspected. The patient was successfully treated with a combined surgical and medical approach.