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Mycobacterium marinum
Pigmented.
Epidemiology:
1) free-living, does not require host
2) disease associated with water exposure, fresh water & salt water
3) causes HIV-associated mycobacterial infection
Pathology:
1) initial lesion is cutaneous granulomatous lesion
2) transmitted via lymphatic to joints
3) mild, slowly progressive tenosynovitis
4) infectious arthritis
5) inoculation osteomyelitis
Clinical manifestations:
1) cutaneous lesions [5] (images)
a) hand is most commonly affected
b) nodular cutaneous papules may progressive to shallow ulcerated lesions
2) inflammatory arthritis localized to the site of the skin lesion
Laboratory:
- synovial fluid culture
- also see Mycobacterium
Management:
- macrolide, tetracycline, & rifabutin [4]
- moxifloxacin, rifampin, & clarithromycin for 6 months [5]
General
Mycobacterium
Properties
KINGDOM: monera
DIVISION: SCHIZOMYCETES
References
- Medical Knowledge Self Assessment Program (MKSAP) 11,15,16,18.
American College of Physicians, Philadelphia 1998,2009, 2012, 2018.
- Harrison's Principles of Internal Medicine, 13th ed.
Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 722
- Cheung JP, Fung B, Wong SS, Ip WY.
Review article: Mycobacterium marinum infection of the hand
and wrist.
J Orthop Surg (Hong Kong). 2010 Apr;18(1):98-103.
PMID: 20427845
- Aubry A, Chosidow O, Caumes E, Robert J, Cambau E.
Sixty-three cases of Mycobacterium marinum infection: clinical features,
treatment, and antibiotic susceptibility of causative isolates.
Arch Intern Med. 2002 Aug 12-26;162(15):1746-52.
PMID: 12153378
- Su Q, Wang F
Images in Clinical Medicine: Painful Nodules on the Arms.
N Engl J Med 2021; 384:e41. March 18
PMID: 33730457
https://www.nejm.org/doi/full/10.1056/NEJMicm2028530