Dermatologic Manifestations of Mycobacterium Marinum Infection of the Skin Treatment & Management

  • Author: Joslyn S Kirby, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jul 25, 2011
 

Medical Care

Treatment is usually medical in nature, using bacteriocidal agents. The duration of therapy is empiric, with the recommendations to continue therapy for 4-6 weeks following clinical resolution of the lesions. Treatment of some infections may last as long as 25 months or longer.[18]

Effective antimicrobials include tetracyclines, fluoroquinolones, macrolides, sulfonamides, and others.

Drug resistance varies and has been reported with all classes of antibiotic treatment listed above. Combination therapy is used for cases with documented antimicrobial resistance or those not responding to single-agent therapy.[18]

Spontaneous resolution has been reported. Treatment with radiation, cryotherapy, and heat probes has been reported.

See Medication for further discussion of single- and combination-agent therapies.

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Surgical Care

Surgical drainage of most skin lesions often is unnecessary.

Infection of deep structures such as the tendon sheaths, joint space, or bone should be managed with the help of a surgeon. Debridement of necrotic tissues of the synovium, tendon sheaths, and/or bone may be needed to control infection in spite of appropriate systemic antibiotic therapy. Amputations are rarely necessary.[19]

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Consultations

A variety of specialists may be involved in the diagnosis and treatment, such as dermatologists, rheumatologists, and infectious disease physicians.

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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.

Specialty Editor Board

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.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster 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.

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.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M 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, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

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