Abstract
Atypical mycobacterioses are unusual infections of the skin and other organs caused by non-tuberculous mycobacteria. Fish tank granuloma and swimming pool granuloma are two forms of atypical mycobacterioses caused by Mycobacterium marinum. So far, only a few cases of these infections have been reported in organ transplant patients, and these usually are more severe when compared with atypical mycobacterioses in immunocompetent hosts. We report a kidney transplant patient with a rather mild form of atypical mycobacteriosis (fish tank granuloma) who responded well to treatment with doxycycline and will provide a review of all similar cases reported in the literature.
Highlights
Organ transplant recipients (OTRs) are at increased risk to develop infectious diseases because of the immunosuppressive treatment administered to prevent graft rejection
We report here a renal transplant recipient who developed fish tank granuloma and briefly review the salient features of Atypical mycobacteriosis (AM) due to M. marinum in this group of patients
Fish tank granuloma is a clinical form of AM due to M. marinum
Summary
Organ transplant recipients (OTRs) are at increased risk to develop infectious diseases because of the immunosuppressive treatment administered to prevent graft rejection. A 72-year-old Caucasian male received a renal allograft at the age of 62 years because of liver-kidney polycystic disease and was thereafter treated with cyclosporin (200 mg/d), steroids (5 mg/d), and mycophenolic acid (720 mg/d) His post-transplant course was complicated by cutaneous warts, multiple actinic keratoses on sun-exposed areas, a squamous cell carcinoma on each ear, and porokeratosis of the shin. Nine years post-graft, he developed a rapidly-growing cutaneous lesion over the right index finger, for which his family physician prescribed an antibiotic treatment (amoxicillin/clavulanic acid, 3 g/d, and local fusidic acid ointment). This treatment proved ineffective; the patient was referred to our specialized outpatient clinic devoted to the care of cutaneous complications in OTR. The immunosuppressive treatment of the patient was reduced (cyclosporin dosage was lowered to 125 mg/d); this was followed by a slight decrease in his renal function
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