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J Clin Aesthet Dermatol 2018 Dec 1;11(12):48-51. Epub 2018 Dec 1.

Ms. Krooks, Dr. Weatherall, and Dr. Markowitz are with the Florida Atlantic University Charles E. Schmidt College of Medicine in Boca Raton, Florida.

A 70-year-old, immunocompetent male presented with mildly painful and pruritic erythematous patches and vesicles on the right dorsal aspect of the distal middle finger present for four weeks. Other skin lesions or systemic symptoms were notably absent. The patient failed to respond to valacyclovir, topical triamcinolone acetonide ointment, trimethoprim-sulfamethoxazole, and cephalexin for presumptive diagnoses of recurrent herpetic whitlow, dyshidrotic eczema, and blistering distal dactylitis, respectively. Read More

Zoonoses Public Health 2019 Feb 24;66(1):164-168. Epub 2018 Aug 24.

Haliburton, Kawartha, Pine Ridge District Health Unit, Port Hope, Ontario, Canada.

In July 2015, a cluster of five suspect cases of clinically diagnosed Mycobacterium marinum (M. marinum) skin infections were reported to the Haliburton, Kawartha, Pine Ridge District Health Unit (HKPRDHU), Ontario, Canada, with two additional cases subsequently identified through case finding. All seven cases presented with cutaneous lesions located on the finger, hand and/or elbow regions typical of M. Read More

Schweiz Arch Tierheilkd 2018 Jun;160(6):385-393

Centre for Fish and Wildlife Health, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern.

Introduction: Piscine mycobacteriosis is a lethal disease with zoonotic potential, found worldwide in both fresh and marine fish. More than 20 strains of Mycobacterium spp. are known to persist in fish so far, but the pathogenicity is currently unknown for most of them. Read More

Infect Chemother 2018 Mar;50(1):59-64

Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.

Mycobacterium marinum infection in humans occurs mainly as a granulomatous infection after exposure of traumatized skin to contaminated water. It is usually confined to the skin and soft tissue. Disseminated disease involving other organs rarely occurs in immunocompetent patients. Read More

Vet Q 2018 Dec;38(1):35-46

f Department of Biochemistry, Faculty of Agriculture , Zagazig University , Egypt.

Mycobacterium marinum is an opportunistic pathogen inducing infection in fresh and marine water fish. This pathogen causes necrotizing granuloma like tuberculosis, morbidity and mortality in fish. The cell wall-associated lipid phthiocerol dimycocerosates, phenolic glycolipids and ESAT-6 secretion system 1 (ESX-1) are the conserved virulence determinant of the organism. Read More

Dermatol Ther 2017 Nov 13;30(6). Epub 2017 Oct 13.

Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Dis Aquat Organ 2017 Mar;123(3):239-249

Graduate Institute of Molecular and Comparative Pathobiology, School of Veterinary Medicine, National Taiwan University, No. 1, Sec. 4, Roosevelt Rd, Taipei 10617, Taiwan.

A mass mortality event of captive Hong Kong warty newts Paramesotriton hongkongensis with non-granulomatous necrotic lesions occurred in Taipei Zoo, Taiwan, in 2014. Clinically, the sick newts were lethargic and often covered with water mold Saprolegnia sp. on the skin of the body trunk or extremities. Read More

G Ital Dermatol Venereol 2016 Oct;151(5):569-70

Department of Pathophysiology and Transplantations, University of Milan, IRCCS Foundation, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy -

Indian J Dermatol Venereol Leprol 2017 Jan-Feb;83(1):133-135

Department of Microbiology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.

Medicine (Baltimore) 2016 Mar;95(11):e3131

From the Divisions of Pulmonary Medicine (TA, MI, HN, ST, TB) and Hematology (TK, TS, SO), Department of Medicine; Division of Diagnostic Pathology (KK); and Center for Infectious Diseases and Infection Control (KS, NH), Keio University School of Medicine; Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases (NN, YH), Tokyo, Japan.

Mycobacterium marinum is a ubiquitous waterborne organism that mainly causes skin infection in immunocompetent patients, and its disseminated infection is rare. Extranodal NK/T cell lymphoma, nasal type (ENKL) usually localizes at the nasal and/or paranasal area, but occasionally disseminates into the skin/soft tissue and gastrointestinal tract. Compromised immunity is a risk factor for developing nontuberculous mycobacterial (NTM) infection and malignant lymphoma, and the 2 diseases may share similar clinical presentation; however, only a few reports have described NTM infection mimicking malignant lymphoma. Read More

Dtsch Med Wochenschr 2016 Feb 17;141(4):245. Epub 2016 Feb 17.

Pediatr Emerg Care 2017 Dec;33(12):e167-e169

Traumatic abrasions on human extremities as a result of direct contact with sea, lake, river, or aquarium animals or from traumatic injuries sustained in seawater may develop into solitary or linear granulomatous lesions. One of the more common microbial etiologies for such infections is Mycobacterium marinum. An astute pediatrician, family physician, or nurse practitioner should have a high index of suspicion and obtain specific cultures to support the growth of Mycobacterium species. Read More

Ann Chir Plast Esthet 2016 Aug 31;61(4):311-5. Epub 2015 Dec 31.

Service de chirurgie plastique, reconstructrice et esthétique, centre SOS main, CHU Ch.-Nicolle, 76031 Rouen, France.

Mycobacterium marinum is an atypical and non-tuberculosis mycobacterium that mainly leads to cutaneous infections. Infections occur through inoculation of the organism through injury to the skin in the presence of contaminated water or fish. The patient often presents with unspecific symptoms and the evolution, in the absence of adequate treatment, is characterized by an expansion of the cutaneous lesion and a spread to deep structures. Read More

Beijing Da Xue Xue Bao Yi Xue Ban 2015 Dec;47(6):939-44

Department of Dermatology, Peking University People's Hospital, Beijing 100044, China.

Objective: To study the clinical and pathological characteristics of sporadic cutaneous infections due to nontuberculous mycobacteria (NTM), and investigate the diagnostic criteria and therapeutic principal.

Methods: Totally 37 cases of sporadic cutaneous infections due to NTM were confirmed in the Department of Dermatology, Peking University People's Hospital from January 2000 to March 2014. The microbiologic and clinical data were reviewed, and their skin biopsy specimens were reassessed. Read More

Clin Infect Dis 2016 Mar 16;62(5):590-5. Epub 2015 Dec 16.

Infectious Diseases Pathology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.

Background: From December 2013 through May 2014, physicians, dermatopathologists, and public health authorities collaborated to characterize an outbreak of Mycobacterium marinum and other nontuberculous mycobacterial skin and soft tissue infections (SSTIs) associated with handling fish in New York City's Chinatown. Clinicopathologic and laboratory investigations were performed on a series of patients.

Methods: Medical records were reviewed for 29 patients. Read More

Dermatol Online J 2015 May 18;21(5). Epub 2015 May 18.

University of Trieste, Italy.

We describe the case of an elderly woman who acquired a Mycobacterium marinum infection following skin exposure to the bacteria through a small wound on her right ring finger, obtained while preparing fish. The resultant sporotrichoid nodules of the right hand and the distal forearm, refractory to the initial therapy with doxycycline and rifampicin, were successfully treated with oral regimen of clarithromycin. Read More

Infection 2015 Dec 14;43(6):655-62. Epub 2015 Apr 14.

Department of Medicine, Duke University Medical Center, Box 102539, 315 Trent Drive, Durham, NC, 27710, USA.

Purpose: Invasive Mycobacterium marinum disease (tenosynovitis and osteomyelitis) may be an increasingly common manifestation of M. marinum infection that presents unique diagnostic and therapeutic challenges. We conducted a retrospective case series and literature review of M. Read More

Acta Dermatovenerol Croat 2017 04;25(1):67-71

Paola Đurinec MD, Department of Dermatology and Venereology, University of Zagreb School of Medicine, University Hospital Center Zagreb, Šalata 4, 10000 Zagreb, Croatia;

M. marinum, a nontuberculous mycobacterium, is a rare human pathogen widely distributed in the aquatic environment. In the previous century, epidemics took place due to inadequately chlorinated swimming pool water. Read More

J Venom Anim Toxins Incl Trop Dis 2015 20;21. Epub 2015 Mar 20.

Instituto Lauro de Souza Lima, Rodovia Comandante João Ribeiro de Barros, km 225/226, Bauru, SP CEP 17.034-971 Brazil.

The infection by Mycobacterium marinum in humans is relatively uncommon. When it occurs, it mainly affects the skin, usually with a chronic, indolent and benign evolution. The diagnosis requires a high index of suspicion, and a significant delay may be observed between the first symptoms to the final diagnosis. Read More

Curr Opin Infect Dis 2015 Apr;28(2):133-8

Dermatology Unit, Medical Department, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, Kuala Lumpur, Malaysia.

Purpose Of Review: We reviewed current literature on four different skin and subcutaneous infections which are often touted as 'emerging diseases' of south-east Asia, namely melioidosis, penicilliosis, sporotrichosis and Mycobacterium marinum infection. Lack of consensus treatment guidelines, high treatment costs and limited investigative capability in certain endemic areas are among the challenges faced by managing physicians. With the increase in borderless travelling, it is hoped that this review will facilitate better understanding and heighten the clinical suspicion of such infections for clinicians in other parts of the world. Read More

Dermatology 2014 11;229(2):83-7. Epub 2014 Sep 11.

Department of Pathophysiology and Transplantation, University of Milan, IRCCS Foundation Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy.

Background: There is no established therapy of choice for Mycobacterium marinum skin infections; clarithromycin monotherapy was used in some anecdotical cases at changeable daily doses and length.

Objective: To evaluate the efficacy and safety of pulsed clarithromycin monotherapy.

Methods: 29 patients with a clinical diagnosis of sporotrichoid fish tank granuloma were admitted from 2002 to 2013. Read More

N Z Med J 2014 Jul 4;127(1397):88-92. Epub 2014 Jul 4.

Department of Infectious Diseases, Christchurch Hospital, PO Box 4345, Christchurch, New Zealand.

Mycobacterium marinum is a rare cause of cutaneous infection. The typical clinical picture consists of one or more discrete well circumscribed lesions affecting the upper limbs. However, a more exuberant form has been described in the South Pacific, where it is sometimes entitled 'Spam disease' given the infected skin's similar appearance to the canned food. Read More

Iran Red Crescent Med J 2014 Feb 5;16(2):e10120. Epub 2014 Feb 5.

Infectious Diseases and Tropical Medicine Department, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran.

Introduction: Mycobacterium marinum infection is the most common nontuberculous mycobacterial skin lesions. It results from skin injury and contact with contaminated water, fish, or shellfish; its infections have low frequency, nonspecific symptoms and lack of specific identification methods that can alter correct diagnosis.This study designed about cases that reported from Iran and comparing their presentation and clinical sign and symptom and outcome. Read More

Int J Infect Dis 2014 Apr 12;21:17-8. Epub 2014 Feb 12.

Aix Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Faculté de Médecine, 27, Boulevard Jean Moulin, 13005 Marseille, cedex 5, France. Electronic address:

A 19-year-old man presented with a 1.5-cm nodule on the first dorsal metacarpal ray. The patient denied having contact with fish tanks or fish, but recalled handling many reptiles without gloves in the vivarium where he worked. Read More

J Drugs Dermatol 2014 Feb;13(2):204-6

Mycobacterium marinum infections are frequently linked to aquatic environments. Cutaneous infections with these organisms cause superficial nodules, ulcerations, and pustules on the skin. Involvement of the deeper tissue may occur when diagnosis and treatment are delayed, allowing the organisms to spread. Read More

Cleve Clin J Med 2014 Feb;81(2):79-80

Department of Dermatology, Valencia University General Hospital, Valencia, Spain.

Biomed Res Int 2013 12;2013:161329. Epub 2013 Dec 12.

Department of Dermatovenerology, General University Hospital and 1st Faculty of Medicine Charles University, 128 21 Prague, Czech Republic.

Mycobacterium marinum, the cause of chronic systemic infections in fish, occasionally causes granulomatous skin and soft tissue lesions in humans. Cutaneous mycobacterial infection in two patients owing to unusual circumstances is presented in this report. The first patient was infected through improper hygienic behavior, while infection in the second patient was previously misdiagnosed as rheumatoid arthritis and treated with methylprednisolone for a period of three months, which resulted in a rare systemic spread of M. Read More

Eur J Dermatol 2013 Jul-Aug;23(4):510-6

Department of Biomedical Science and Human Oncology Section of Dermatology.

Mycobacterium marinum is a non-tuberculous photochromogenic mycobacterium, commonly responsible for fish and amphibious infections world-wide. Contagion in humans typically follows minor hand trauma from aquarium keeping and manifests as a granulomatous infection of the skin. Dissemination is rare and almost exclusive to immunosuppressed hosts. Read More

Australas J Dermatol 2014 Nov 29;55(4):e77-9. Epub 2013 Aug 29.

Department of Medicine (Dermatology), St. Vincent's Hospital Melbourne, Australia; Skin and Cancer Foundation Inc.

An 82-year-old woman on long-term prednisolone for chronic obstructive airways disease presented with a 2-month history of nodules on her left forearm. This occurred 10 years after nodules on her right forearm caused by a culture-proven Mycobacterium marinum infection. Histopathological examination, polymerase chain reaction and culture of biopsy specimens were positive for M. Read More

J Plast Surg Hand Surg 2013 Dec 26;47(6):532-4. Epub 2013 Aug 26.

Department of Hand Surgery, Skåne University Hospital , Malmö

Mycobacterium marinum infection of the hand is rare. We report the case of a 39-year-old man with M marinum infection that resulted in a chronic soft tissue infection, extensor tendon synovitis, and arthritis of the metacarpophalangeal (MCP) joints. The cause was probably tropical freshwater fishes. Read More

Drug Des Devel Ther 2013 29;7:669-80. Epub 2013 Jul 29.

Chinese Academy of Medical Sciences and Peking Union Medical College, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, Jiangsu, People's Republic of China.

Purpose: The aim of the present study was to investigate the immune response induced by Mycobacterium marinum infection in vitro and the potential of M. marinum as an immunotherapy for M. tuberculosis infection. Read More

J Dermatol 2013 Sep 9;40(9):773-4. Epub 2013 Jul 9.

Department of Dermatology, Dong-A University College of Medicine, Busan, Korea.

Int J STD AIDS 2013 Jan 6;24(1):75-7. Epub 2013 May 6.

Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Bournemouth, UK.

Mycobacterium marinum is a rare non-tuberculous mycobacterium known commonly to cause fish tank granuloma. It is found in aquatic surroundings and is common in healthy individuals. We report a case and review the literature in an immunocompromised HIV-1 individual with a first reported case of a rifampicin-resistant M. Read More

J Dermatol Sci 2013 Jun 9;70(3):166-72. Epub 2013 Feb 9.

Department of Dermatology, Fukuoka University School of Medicine, Fukuoka, Japan.

Background: 1α,25-Dihydroxyvitamin D3 (1,25(OH)2D3) up-regulates the production of human cathelicidin antimicrobial peptide (CAMP) from monocytes/macrophages infected with Mycobacterium tuberculosis (M. tbc). CAMP facilitates the co-localization of autophagolysosomes with M. Read More

Can Fam Physician 2013 Jan;59(1):51, 53-4

University of Calgary, Alberta.

Ugeskr Laeger 2012 Dec;174(50):3176-7

Dermato-allergologisk Afdeling, Gentofte Hospital, Denmark.

The diagnosis of cutaneous Mycobacterium marinum infection is often delayed for months after presentation. In this case the diagnosis and correct treatment was delayed for ten months resulting in possible irreversible damage to the patient's infected finger. The main reason for the delay is lack of knowledge of the mycobacterium. Read More

Clin Interv Aging 2012 22;7:533-8. Epub 2012 Nov 22.

Key Laboratory of Molecular Biology for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.

Background: The incidence of Mycobacterium marinum infection has been increasing. First-line antituberculous drugs and other common antibiotics are effective for most cutaneous M. marinum infections; however, treatment failure still occurs in some rare cases. Read More

J Crohns Colitis 2013 Feb 5;7(1):e15-8. Epub 2012 Jul 5.

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Austria.

Opportunistic infections, especially reactivation with M. tuberculosis, are major complications during treatment with anti-TNF agents. Infections with atypical mycobacteria like Mycobacterium marinum are rare and tend to turn into a difficult and prolonged course due to delayed diagnosis. Read More

Kansenshogaku Zasshi 2012 Mar;86(2):139-43

Department of Respiratory Tract Medicine, Kansai Electric Power Hospital.

Mycobacterium marinum is a waterborne mycobacterium that commonly infects fish and amphibians worldwide, but transmission to humans can occasionally occur, typically as a granulomatous skin infection following minor hand trauma. Infection involving the lungs is very rare. We herein describe a case of M. Read More

J Dermatol 2012 Nov 13;39(11):970-1. Epub 2012 Mar 13.

Hautarzt 2012 Sep;63(9):716-8

Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Ricklinger Str. 5, 30449, Hannover, Deutschland.

Cutaneous infections with Mycobacterium marinum are rare. They also are known as swimming pool or fish tank granulomas. Often the history of contact with contaminated water associated with microtrauma of the upper extremities leads to the correct diagnosis. Read More

Transpl Infect Dis 2012 Aug 8;14(4):410-4. Epub 2011 Sep 8.

Division of Infectious Diseases, New York Presbyterian Hospital - Weill Cornell, New York, New York, USA.

Mycobacterium marinum is a photochromogenic mycobacterium that is ubiquitous in the aquatic environment. In the general population, exposure to aquaria is the most common cause of M. marinum infection. Read More

J Am Acad Dermatol 2011 Nov;65(5):1060-2

Diagn Microbiol Infect Dis 2011 Nov;71(3):267-72

Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing City, Jiangsu Province 210042, China.

Mycobacterium marinum is a slow-growing mycobacterium. In November 2008, we diagnosed a patient with M. marinum infection who worked at a fish farm in Jiangsu Haian, China. Read More

Acta Clin Belg 2011 Jul-Aug;66(4):315-7

Department of Internal Medicine, CHU-Charleroi, A. Vésale Hospital, Charleroi, Belgium.

We report a skin Mycobacterium marinum infection presenting as wide ulcerative lesions of the arm (4 cm for the widest) in a hypoxic COPD patient who takes 4 mg methylprednisolone daily and higher doses during exacerbations. Diagnostic delay as well as glucocorticoid use could be responsible for the extension of the lesions. Clinical resolution occurred after three months of antibiotic therapy. Read More

Case Rep Dermatol 2011 May 10;3(2):137-41. Epub 2011 Jul 10.

Department of Dermatology, ULB Hôpital Erasme, Brussels, Belgium.

We report the case of a 35-year-old man with a chronic ulceration of the hand in whom an infection with Mycobacterium marinum was diagnosed. Clarithromycin and doxycycline were prescribed, resulting in a slow resolution of the ulceration. M. Read More

Hautarzt 2011 Apr;62(4):266-71

Haut- und Laborarzt/Allergologie, Andrologie, Labor für medizinische Mikrobiologie, Straße des Friedens 8, 04579 Mölbis, Deutschland.

Mycobacterium marinum belongs to the non-tuberculous or "atypical" mycobacteria. The reservoirs for these ubiquitous and slowly growing bacteria are both fresh water and salt water. In particular, aquaria should be considered as important source of hobby-related infections especially of fingers, hands and forearms. Read More

Br J Haematol 2011 Apr 17;153(2):148. Epub 2011 Feb 17.

Department of Haematology, Basildon University Hospital, Essex, UK.

Ann Dermatol Venereol 2011 Jan 30;138(1):17-22. Epub 2010 Nov 30.

Laboratoire d'histopathologie, clinique dermatologique, hôpitaux universitaires de Strasbourg, 1 place de l'Hôpital, Strasbourg cedex, France.

Introduction: Skin infection by Mycobacterium marinum induces the classic granuloma of aquariums and swimming pools. The histopathological signs have been described primarily in small series of typical cases, generally with no bacteriological evidence. In a national survey of proven infection with M. Read More

Caspian J Intern Med 2011 ;2(1):198-200

Department of Fishery Sciences, Islamic Azad University, Babol, Iran.

Background: Mycobacterium marinum infection has a worldwide distribution and the organism occupies many aquatic environments. Infections in human consist of nodular cutaneous lesions that can progress to tenosynovitis, arthritis, and osteomyelitis. Case presentation : A 27-year-old man was presented with a history of swelling and exudative erythematous lesions and pustules of the right forearm. Read More