M. marinum (Fish Tank Granuloma) | Figure 4.19
A: Erythema nodosum
leprosum, arm
(Courtesy of Dr. Paul Getz)
B: Fish tank granuloma
C: Buruli ulcer
(Courtesy of CDC) |
(Figure 4.19B) - Infection follows traumatic inoculation during exposure to an aquatic environment where M. marinum resides as a normal saprophyte (lakes, fish tanks, etc.)
- Presents as a slow-growing blue-red papule at the site of inoculation, ± ascending lymphatic sporotrichoid spread; immunosuppressed patients with disseminated lesions
- Diagnosis: tissue culture (grows in 2–4 weeks at 32°C, not 37°C), biopsy suggestive (not pathognomonic)
- Treatment: minocycline, doxycycline, trimethoprim-sulfamethoxazole, or clarithromycin for at least 1–2 months after resolution
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