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Mycobacterium marinum infection in Adult
See also in: Cellulitis DDx
Other Resources UpToDate PubMed

Mycobacterium marinum infection in Adult

See also in: Cellulitis DDx
Contributors: Amy Kalowitz Bieber MD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Mycobacterium marinum, the causative agent of fish tank or swimming pool granuloma, is an atypical mycobacterial skin infection often contracted from contaminated fish tanks, swimming pools, and ocean and lake water. It is found in both fresh- and saltwater environments. Minor trauma is a predisposing factor. Aquarium enthusiasts and fish and seafood market workers are usually not aware of the risk of infection. Because of occupational risks (eg, fisherman), men are more commonly affected than women.

The typical skin lesion consists of a pustule or nodule and develops on an extremity 2-3 weeks after exposure. Nodules may ulcerate, suppurate, and spread via lymphangitic spread (about 25% of cases). In more severe infections, deeper manifestations such as tenosynovitis, arthritis, bursitis, or osteomyelitis may be seen. In immunosuppressed patients, disease can disseminate to the lungs or other systems; bacteremia is rare.

In general, the infection is usually mild and self-limited, and lesions may heal over a period of 1-2 years if left untreated, although treatment is recommended.

Related topics: Mycobacterium avium-intracellulare, Mycobacterium kansasii, Mycobacterium fortuitum, Mycobacterium chelonae, Mycobacterium scrofulaceum, Mycobacterium tuberculosis, and Atypical mycobacterial infections

Codes

ICD10CM:
A31.9 – Mycobacterial infection, unspecified

SNOMEDCT:
373438001 – Infection due to Mycobacterium marinum

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Immunocompromised patients are more susceptible to the deep fungal, bacterial, and atypical mycobacterial infections listed above. Also consider:
  • Bacillary angiomatosis can be seen in human immunodeficiency virus (HIV)- / AIDS-infected patients with low CD4 counts or patients who are otherwise immunocompromised.
  • Kaposi sarcoma is a consideration in patients with HIV / AIDS.

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:10/15/2019
Last Updated:11/26/2019
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Mycobacterium marinum infection in Adult
See also in: Cellulitis DDx
Mycobacterium marinum infection : Fish exposure, Lymphangitic distribution, Skin ulcer, Smooth nodule
Clinical image of Mycobacterium marinum infection
An ulcerated, bright red nodule on the thumb and a nearby smooth, pink papule, on the dorsal hand.
Copyright © 2021 VisualDx®. All rights reserved.