eMedicine Specialties > Dermatology > Mycobacterial Infections

Mycobacterium Marinum Infection of the Skin: Follow-up

Author: Joslyn S Kirby, MD, Assistant Professor, Department of Dermatology, Milton S Hershey Penn State Medical Center
Coauthor(s): Ellen J Kim, MD, Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania; Saeed Jaffer, MD, MS, Assistant Clinical Professor, University of California at Los Angeles School of Medicine, Consulting Staff, Boston Dermatology
Contributor Information and Disclosures

Updated: Jul 13, 2009

Follow-up

Further Inpatient Care

  • Patients can be treated in an outpatient setting and should be seen frequently until they begin to respond to therapy, then less frequently until the infection is fully cured. Patients may benefit from seeing an infectious disease physician in an outpatient setting.

Deterrence/Prevention

  • People who work near or in salt water should take precautions to avoid abrasions, trauma, or bites from fish and marine animals.
  • People who work with aquariums should wear gloves if they are cleaning tanks or expect to encounter trauma to their hands or feet.
  • If bites or abrasions occur, cleanse the skin, apply an antibacterial preparation, and dress with an appropriate bandage.

Complications

  • Persistent ulceration
  • Osteomyelitis, bony erosion
  • Bursitis
  • Tenosynovitis
  • Arthritis
  • Disseminated infection

Prognosis

  • Once identified and appropriately treated, M marinum infection can typically be successfully eradicated, usually with no major sequelae.

Miscellaneous

Medicolegal Pitfalls

  • Sporotrichosis is most commonly associated with nodular lymphangitis. For this reason, M marinum infection can often be misdiagnosed as sporotrichosis. Patients sometimes undergo long courses of antifungal treatments before further spreading of the Mycobacterium elicits a repeat biopsy and culture.
  • Involved joints may be misdiagnosed as inflammatory arthritis, and the joint may be inappropriately injected with a corticosteroid. Corticosteroid injection can result in marked progression of the disease.19
 


More on Mycobacterium Marinum Infection of the Skin

Overview: Mycobacterium Marinum Infection of the Skin
Differential Diagnoses & Workup: Mycobacterium Marinum Infection of the Skin
Treatment & Medication: Mycobacterium Marinum Infection of the Skin
Follow-up: Mycobacterium Marinum Infection of the Skin
References
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References

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  4. Appelgren P, Farnebo F, Dotevall L, Studahl M, Jonsson B, Petrini B. Late-onset posttraumatic skin and soft-tissue infections caused by rapid-growing mycobacteria in tsunami survivors. Clin Infect Dis. Jul 15 2008;47(2):e11-6. [Medline].

  5. S Breza T Jr, Magro CM. Lichenoid and granulomatous dermatitis associated with atypical mycobacterium infections. J Cutan Pathol. Jul 2006;33(7):512-5. [Medline].

  6. Lam A, Toma W, Schlesinger N. Mycobacterium marinum arthritis mimicking rheumatoid arthritis. J Rheumatol. Apr 2006;33(4):817-9. [Medline].

  7. Gluckman SJ. Mycobacterium marinum. Clin Dermatol. May-Jun 1995;13(3):273-6. [Medline].

  8. Bhambri S, Bhambri A, Del Rosso JQ. Atypical mycobacterial cutaneous infections. Dermatol Clin. Jan 2009;27(1):63-73. [Medline].

  9. Wongworawat MD, Holtom P, Learch TJ, Fedenko A, Stevanovic MV. A prolonged case of Mycobacterium marinum flexor tenosynovitis: radiographic and histological correlation, and review of the literature. Skeletal Radiol. Sep 2003;32(9):542-5. [Medline].

  10. Mahaisavariya P, Chaiprasert A, Manonukul J, Khemngern S, Tingtoy N. Detection and identification of Mycobacterium species by polymerase chain reaction (PCR) from paraffin-embedded tissue compare to AFB staining in pathological sections. J Med Assoc Thai. Jan 2005;88(1):108-13. [Medline].

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  26. Oliver JD. Wound infections caused by Vibrio vulnificus and other marine bacteria. Epidemiol Infect. Jun 2005;133(3):383-91. [Medline].

  27. Ryan JM, Bryant GD. Fish tank granuloma--a frequently misdiagnosed infection of the upper limb. J Accid Emerg Med. Nov 1997;14(6):398-400. [Medline].

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Further Reading

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Keywords

mycobacterial skin infection, fish tank granuloma, tropical fish tank granuloma, M marinum, Mycobacterium, Mycobacterium marinum, mycobacteria other than tuberculosis, MOTT, nontuberculous mycobacteria, mycobacteria, acid-fast mycobacteria, saltwater infection, freshwater infection, marine infection, marine bacteria, water-borne bacteria, water-borne bacterial infection

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Contributor Information and Disclosures

Author

Joslyn S Kirby, MD, Assistant Professor, Department of Dermatology, Milton S Hershey Penn State Medical Center
Joslyn S Kirby, MD is a member of the following medical societies: American Academy of Dermatology, International Society for Cutaneous Lymphomas, Pennsylvania Academy of Dermatology, and Women's Dermatologic Society
Disclosure: Nothing to disclose.

Coauthor(s)

Ellen J Kim, MD, Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania
Ellen J Kim, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Dermatology Foundation, Medical Dermatology Society, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Saeed Jaffer, MD, MS, Assistant Clinical Professor, University of California at Los Angeles School of Medicine, Consulting Staff, Boston Dermatology
Saeed Jaffer, MD, MS is a member of the following medical societies: American Academy of Dermatology and American Society for MOHS Surgery
Disclosure: Nothing to disclose.

Medical Editor

Terry L Barrett, MD, Clinical Professor of Dermatology and Pathology, University of Texas Southwestern School of Medicine; Director, ProPath Dermatopathology, Dallas, Texas
Terry L Barrett, MD is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, American Medical Association, American Society of Dermatopathology, College of American Pathologists, and United States and Canadian Academy of Pathology
Disclosure: Nothing to disclose.

Pharmacy Editor

Richard P Vinson, MD, Assistant Clinical Professor, Department of Dermatology, Texas Tech University School of Medicine; Consulting Staff, Mountain View Dermatology, PA
Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Lester F Libow, MD, Dermatopathologist, South Texas Dermatopathology Laboratory
Lester F Libow, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Texas Medical Association
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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