Abstract

Mycobacterium marinum causes human disease through direct inoculation into the skin when handling infected fresh, brackish, or sea water. Primarily, this is an infection of fish, amphibians, snakes, eels, and lizards. It represents an occupational risk for veterinary doctors, the general population with a fish tank at home, and particularly for immune-suppressed individuals. The clinical presentation is typical in most patients. Smooth or warty nodules, single or multiple in a lymphangitic pattern and sporotrichoid, are developed within 2 to 8 weeks of contact and inoculation. Fingers, hands, and upper limbs are the most common unilateral involved regions. The infection can rarely spread affecting deeper tissues, tendons, and joints. A clinical diagnosis supported by the well-recorded history of exposure justifies a therapeutic intervention with combinations of anti-mycobacterial drugs. The daily oral treatment is given for 2 to 4 weeks, with clinical cure commonly achieved in 4 to 6 months. Relapses are not uncommon.

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