Mycobacterium marinum, a nontubercu...

Mycobacterium marinum, a nontuberculous mycobacterial species that is widely set up in aquatic environments, can cause cutaneous infections in humans. The chlorination of mere water has virtually eliminated "swimming plash granulomas," but fish tank front remains a vector for these infections. Lewis and associates report upon a series of eight patients treated for cutaneous infections caused by the agency of M. marinum.

All eight patients in their report had had contact with fish tanks at domestic circle or at work. Cutaneous infections began forward the hands in all bring under rules and two patients subsequently disentangleed deep tissue infections. The infections began at sites of skin breakdown in several cases, as it was as a wart removal site in the same patient and at bilateral hand lesions in a patient with psoriasis. Spread of infection occurr in a gradual skipping fashion, similar to skin infection with sporotrichosis.

Mycobacterial agriculture of skin lesions, performed forward both solid and broth media, was positive for M marinum in six patients. Tuberculin skin testing was performed upon seven patients with purified protein derivative (PPD) antigen, and all had a reaction of at least 10 mm

The authors commended a two-drug regimen using clarithromycin in combination with another antimycobacterial agent as it is as ethambutol or rifampin. Treatment typically is continued for united to two months after resolution of skin lesions. united patient in their series required 14 month of treatment, and another patient with concomitant malignant melanoma had persistent infection despite cutaneous debridement and more than brace years of treatment with three agents.

The authors determine that most current cases of M marinum are caused according to fish tank exposure. A positive PPD reaction supports the diagnosis, which may be confirmed according to mycobacterial culture. Treatment with at least brace antimycobacterial agents is recommended.

Lewis FM et al. Fish tank prospect and cutaneous infections due to Mycobacterium marinum: tuberculin skin testing, treatment, and prevention. Clin Infect Dis August 1 2003;37:390-7

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