Mycobacterium marinum Infection Treatment & Management

Updated: Jun 04, 2019
  • Author: Shirin A Mazumder, MD, FIDSA; Chief Editor: Mark R Wallace, MD, FACP, FIDSA  more...
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Treatment

Medical Care

The mainstay of treatment in M marinum infection is antimicrobial therapy. The duration of therapy is not well defined, but treatment of skin and soft-tissue infections should be continued for 1-2 months after resolution of symptoms and lesions. Therefore, the treatment duration is typically 3-4 months, longer if deeper structures are involved. Some authors have suggested a minimum duration of 6 months. In some cases, a treatment duration of up to 2 years has been reported. Combination treatment with 2 active agents is preferred, although success has been obtained with single-agent approach. Spontaneous resolution of M marinum infection has been reported.

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Surgical Care

Surgical drainage of skin lesions may be unnecessary. A French study revealed no clear benefit or change in outcome using a concomitant surgical approach. Deeper-structure infections may require surgery, although its definite role is not well established. Reports have suggested that antibiotic therapy alone is enough to cure most patients and that additional surgical debridement provides cure in remaining cases.

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Consultations

An infectious disease specialist can establish the diagnosis and suggest management. A dermatologist can also provide expertise.

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Prevention

People who work near salt water should take precautions to avoid abrasions, trauma, or bites from fish and marine animals.

People who work in aquariums should wear gloves if they are cleaning tanks or expect to encounter trauma to their hands or feet.

If abrasions or bites occur, cleanse the skin with an antibacterial preparation and dress with an appropriate bandage.

Recommended concentrations of free chlorine in swimming pool water should be kept between 0.4 and 1 mg/L. [10]

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Long-Term Monitoring

Patients with M marinum infection are treated in an outpatient setting.

Follow-up visits with patients should be scheduled weekly until they begin to respond to therapy and then biweekly until the infection is fully cured.

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Inpatient & Outpatient Medications

Continue combination therapy or monotherapy 1-2 months after the infection resolves.

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Transfer

Transfer to other facilities is unnecessary.

Refer patients with M marinum infection to an infectious diseases physician or a dermatologist in an outpatient clinical setting.

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