Aquarium Associated M. marinum infections may be under-recognized

George Alangaden MD Senior Staff Physician, Transplant Infectious Diseases Medical Director of Infection Prevention Henry Ford Hospital Professor of Medicine, Wayne State University Infectious Diseases, CFP-316 Detroit, MI  48202MedicalResearch.com Interview with:
George Alangaden MD
Senior Staff Physician, Transplant Infectious Diseases
Medical Director of Infection Prevention
Henry Ford Hospital
Professor of Medicine, Wayne State University
Infectious Diseases, CFP-316
Detroit, MI  48202

MedicalResearch.com: What are the main findings of the study?

Dr. Alangaden:

  • Infections caused by Mycobacterium marinum infections are rare. A total of 5 patients were identified in our hospital over a 10 year period.
  • In all instances the infection affected the skin and soft tissues of the hand and arm and presented as sores or bumps on the skin that did not improve after usual antibiotic therapy.
  • All patients had an history of some trauma to the hand and subsequent exposure to water  from home aquariums
  • The time to onset of infection after exposure ranged from 11 days to 56 days.
  • The median time from infection to diagnosis and appropriate therapy was 161 days (range 33-379 days).
  • In all cases the diagnosis was made by doing a skin biopsy.
  • All patients were cured after several weeks of treatment with appropriate antibiotics.

Dr. Alangaden:

MedicalResearch.com: Were any of the findings unexpected?

  • Cases of M. marinum infection have been reported before and the main point as noted in our study is the prolonged delay in diagnosis of this infection.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Alangaden:

  • Suspect M. marinum infections in patients with ulcers or nodules on the hands and arms that do not respond to usual antibiotic therapy. Always inquire about any exposure to water in home aquariums in such cases.
  • Recommend a skin biopsy to make the diagnosis.
  • Inform the laboratory that M. marinum is suspected so that appropriate cultures can be performed.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Alangaden:

  • Patients should avoid cleaning aquariums if they have any cuts or sores on their hands and to use gloves if doing so.

Citation:
Mycobacterium marinum frequently underdiagnosed.

Abstract presented at:

The Infectious Diseases Society of America’s annual meeting in San Francisco.

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