Diagnostic Considerations

Also consider the following:

Infection with atypical mycobacteria (eg, Mycobacterium kansasii, Mycobacterium chelonae, Mycobacterium avium-intracellulare, Mycobacterium ulcerans) ^[22]
Chromoblastomycosis ^[23]
Tinea manuum ^[24]
Botryomycosis ( Staphylococcus aureus)
Deep fungal infection (eg, with Cryptococcus neoformans, Histoplasma capsulatum, Coccidioides immitis, or Blastomyces dermatitis)
Dematiaceous fungi (chromomycosis or phaeohyphomycosis)
Infection with Francisella tularensis
Rheumatoid arthritis ^[25]
Erythema elevatum diutinum

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.^[26]

Differential Diagnoses

Workup

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Media Gallery

Photograph of Mycobacterium marinum infection lesions.

of 1

Author

Kirstin Altman, MD Assistant Professor of Dermatology, Texas A&M Health Science Center College of Medicine

Kirstin Altman, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Texas Dermatological Society

Disclosure: Nothing to disclose.

Coauthor(s)

Tahmina Mahmood, MD Resident Physician, Department of Dermatology, Baylor Scott and White Healthcare System

Disclosure: Nothing to disclose.

Specialty Editor Board

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, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

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, Texas Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

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

Disclosure: Nothing to disclose.

Additional Contributors

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, Women's Dermatologic Society, International Society for Cutaneous Lymphomas, Pennsylvania Academy of Dermatology

Disclosure: Nothing to disclose.

S Alison Basak, MD, MA Resident Physician, Department of Dermatology, Penn State Hershey Medical Center

S Alison Basak, MD, MA is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Pennsylvania Medical Society, Women's Dermatologic Society, Pennsylvania Academy of Dermatology

Disclosure: Nothing to disclose.

Acknowledgements

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.