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Volume 9, Number 11—November 2003
Letter

Invasive Mycobacterium marinum Infections

Timothy Lahey*Comments to Author 
Author affiliation: *Harvard Medical School, Boston, Massachusetts, USA

Main Article

Table

Summary of Invasive Mycobacterium marinum infection cases published since 1966

Ref. Age Sex Symptoms Source Immune impairment Dx delay (mo) Medications Surgery ? Treatment duration (mo)
(2) 32 M Disseminated cutaneous, larynx Minor trauma Systemic steroids 240 I, S Yes >36
(3) 37 M R middle finger osteomyelitis Fishing injury Local steroid injection 3 Erythromycin, S Yes 5
(3) 30 M R long finger osteomyelitis Minor trauma None 12 Declined No --
(3) 56 M R ring finger tenosynovitis Minor trauma, fishing and cleaning boats Local steroid injection 1.2 E Yes 9
(3) 52 M L index finger osteomyelitis and synovitis None Local steroid injection 7 Cycloserine, ethionamide, R Yes ?
(3) 60 M R ring finger synovitis and osteomyelitis Shrimp cleaning injury None 7 E, R Yes 6
(3) 55 M L long finger synovitis and skin ulcer Shrimp cleaning injury None 23 E Yes 6
(4) 30 M Disseminated skin nodules, lymphangitis Aquarium cleaning Systemic steroids and azathioprine for renal transplant 2 E, R, T No ?
(5) 1.3 F Disseminated cutaneous nodules Aquarium exposure None 2 E, I, R No 8
(6) 26 M R hand tenosynovitis Fisherman Local steroid injection 8 E, P, R, tetracycline Yes ?
(6) 45 M R index tenosynovitis Saltwater fishing Local steroid injection 1 E, R, tetracycline Yes ?
(6) 22 M R hand tenosynovitis Fisherman None 2 I, R, S Yes ?
(6) 56 F L hand tenosynovitis Fishing injury Local steroid injections 5 I, R, S Yes ?
(6) 53 M R hand and forearm synovitis, bursitis Fisherman Local steroid injections 78 E, I, R, S Yes ?
(7) 47 F R hand tenosynovitis and osteomyelitis None None 1 E, I, R Yes ?
(8) 32 M L hand tenosynovitis None Local steroid injection 1 E, R, sulfamethoxazole Yes 24
(8) 42 M L hand tenosynovitis Shrimp fishing None 3 E, I, R Yes 24
(8) 52 F R hand tenosynovitis Shrimp spine injury None 1 D, E, R No 24
(8) 31 F L index finger tenosynovitis Crab bite Local steroid injection 6 D, E, R Yes 24
(9) 56 M L index finger osteomyelitis and wrist synovitis Fisherman Local steroid injections 12 E, M, R Yes 9
(10) 5 M Polyarthritis, disseminated skin lesions, hepatic function abnormalities None Abnormalities in monocyte function 48 A, clofazamine, E, R, T No 9
(11) 35 F L hand and wrist septic arthritis, cutaenous lesions on arm Puffer fish sting Systemic steroids for SLE flares 18 M No >12
(12) 62 F L middle finger osteomyelitis with skin nodules Injury while gardening, owned tropical fish aquarium None 8 E, R Yes 4
(13) 33 M R hand nodules, LAD, pneumonia, bacteremia Fish tank AIDS (CD4<5) 0.5 C, clofazimine, ethionamide Yes 3 until death
(14) 56 M L ring finger septic arthritis, osteomyelitis Minor trauma, fish tank Local steroid injection 2 C, E, R No 12
(15) 0.25 M Diffuse pustules, osteomyelitis, bacteremia Bathed in bathtub in which fishtank washed SCID ? I, R, T No 6 until death
(16) 71 M R 2nd MCP synovitis, septic arthritis, osteomyelitis Swimming and fishing injury Local steroid injection 9 C, E, I, R Yes 12
(17) 48 F L hand osteomyelitis, R forearm cutaneous lesions, R ankle septic arthritis and osteomyelitis Fish tank cleaning Cyclosphosphamide and systemic steroids for polymyositis 10 D, I pyrazinamide, R Yes 5
(18) 52 F R hand tenosynovitis and osteomyelitis Fish dealer, puncture injury Systemic steroids and local herbal injections 2 Clarithromycin, D, E, I, R Yes 18
(19) 41 F R index flexor sheath tenosynovitis Fishmonger Local steroid injection 3 M Yes 1.5
(20) 53 M R middle finger tenosynovitis, septic arthritis, wrist osteomyelitis, discharging sinuses Nonpenetrating trauma, home aquarium Local steroid injections, systemic methotrexate 24 C, E, R, S No 13
(21) 81 M L forearm plaque, L index finger ulcer, R forearm cellulitis, bone marro cx + pancytopenia Aquarium exposure Systemic steroids and azathioprine for myasthenia gravis 5 C, D No <1 before death
(22) 22 M R wrist tenosynovitis, nodular skin lesions “Fish-related hobby”, aquarium Systemic steroids for Still’s disease 0.25 C, clarithromycin, E, R Yes 4
(23) 70 M R hand and wrist tenosynovitis, subcutaneous nodules, L knee septic arthritis Fish fin wound Systemic steroids 12 A, E, M, R Yes 12
(24) 60 F Disseminated ulcerating abscesses Tropical aquarium Systemic steroids and chemotherapy for non-Hodgkin lymphoma 8 clarithromycin, clotrimazole, E, immunoglobulins, levofloxacin, R, S, No ?

aDx, diagnosis; l, left; R, right; MCP,metacarpophalangeal; A, amikacin; C, ciprofloxacin; D, doxycycline; E, ethambutol; I, isoniazid; M, minocycline; P, pyrazinamide; R, rifampin; S, streptomycin; T, trimethoprim/sulfamethoxazole

Main Article

References
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Page created: January 21, 2011
Page updated: January 21, 2011
Page reviewed: January 21, 2011
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