Mycobacterium marinum infection.

Contaminated water in swimming pools or tropical fish aquaria is the usual source of Mycobacterium marinum skin infection. Many patients give a history of preceding minor skin trauma. Successful culture of the organism from biopsy confirms the diagnosis. Spontaneous resolution frequently occurs, but, where treatment is considered necessary, a trimethoprim-sulphamethoxazole regime has proved extremely effective.     

Mycobacterium marinum infections treated with tetracycline.

Five cases of Mycobacterium marinum skin infections were successfully treated with 2 gm of tetracycline hydrochloride daily for periods from four to 12 weeks. In each case, the isolated M marinum was sensitive in vitro to tetracycline at levels from 25 to 50 microgram/ml. Tetracycline is recommended as treatment for extensive or sporotrichoid M marinum infections.     

Mycobacterium marinum infection

A 49-year-old man presented with nodules on his right hand after a history of Mycobacterium marinum infection recently treated with rifampin and clarithromycin. The patient has an aquarium with Betta fish (Siamese fighting fish).     

Kutane Infektion mit Mycobacterium marinum

Zusammenfassung Wir berichten über 2 Patienten mit einer kutanen Mycobacterium-marinum-Infektion. Nach kultureller Erregerisolation kam es unter systemischer Kombinationstherapie mit Rifampicin und Clarithromycin innerhalb von 3 Monaten zu einer deutlichen Verbesserung des Hautbefundes.     

Mycobacterium marinum with different responses to second-generation tetracyclines

BACKGROUND: Persistent cutaneous infections with Mycobacterium marinum can follow exposure of injured skin to contaminated water or fish, and can be treated with second-generation tetracyclines in addition to other antimicrobials. Due to the rarity of this infection, there are few data comparing the different treatment alternatives. METHODS: We report a patient with culture-proven M. marinum who was treated with two different second-generation tetracyclines. RESULTS: Our patient failed a 4-week trial of doxycycline, but responded rapidly to minocycline. CONCLUSION: This case suggests that, despite a similar mechanism, pharmacokinetics, and even sensitivity, these two agents may differ in their effectiveness against strains of M. marinum.     

Amikacin treatment for Mycobacterium marinum infection

This report describes a case of Mycobacterium marinum skin infection. A granulomatous plaque on the dorsum of the left hand of a 71-year-old man who kept a tank of tropical fish was followed by erythema and induration on the left forearm of the lymphocutaneous type. The lesion was successfully treated with 6 weeks of administration of amikacin (28 intramuscular injections) a total of 3500 mg. The isolated M. marinum strain was sensitive in vitro to amikacin at 0.78 μg/ml. Furthermore, another 15 clinical strains of M. marinum showed high sensitivity in vitro to this drug (93% of the 16 strains were sensitive to between 0.78 and 1.56 μg/ml).     

Identification of Mycobacterium marinum in sea-urchin granulomas

BACKGROUND: Sea-urchin granuloma is a chronic granulomatous reaction arising after injury with sea-urchin spines. Classified as an allergic foreign-body type of granuloma, it is believed to be a delayed-type reaction to an as yet unidentified antigen. In a clinicopathological study, 50 biopsy specimens from 35 patients diagnosed as having sea-urchin granuloma caused by Paracentrotus lividus, we found different inflammatory patterns that in some cases suggested a mycobacterial infection. OBJECTIVES: To investigate and identify mycobacterial DNA in formalin-fixed and paraffin-embedded skin biopsy specimens diagnosed as sea-urchin granulomas. METHODS: A search combining polymerase chain reaction amplification using Mycobacterium genus-specific primers, and subsequent restriction enzyme analysis enabling identification to the species level, was performed in 41 samples. RESULTS: Amplification of a 924-bp DNA fragment encoding mycobacterial 16S rRNA gene was positive in eight biopsy specimens from seven patients (21%). M. marinum-specific restriction patterns were identified in three samples. CONCLUSIONS: Although further controlled studies are necessary, from these data it would appear that mycobacteria may play a pathogenic role in some cases of sea-urchin granuloma.     

海分枝杆菌感染一例

患者,女,73岁.右上肢皮疹3个月,出疹前半个月有海鱼刺伤史.皮肤科检查:右上肢可见数枚半球形红色丘疹和结节,直径0.3～1.5 cm,沿淋巴管分布.皮损组织病理检查:表皮棘细胞增生,真皮内可见以中性粒细胞为主的混合炎症细胞浸润,偶见多核巨细胞.结核感染T细胞斑点试验(T-SPOT.TB)阳性,病原宏基因组学检测示海分...     

海分枝杆菌感染一例

患者,女,57岁.右上肢结节3个月.组织病理检查为感染性肉芽肿性改变.PAS未见菌丝和孢子结构,抗酸染色阴性.海分枝杆菌qPCR阳性.诊断:海分枝杆菌感染.给予多西环素、克拉霉素、利福平等治疗,皮损逐渐消退.