Ver el código de «Mycobacterium marinum»

==Background==
*Atypical [[Mycobacterium]] species found in fresh or salt water (cold or warm)
*Bacteria that causes "fish tank Granuloma"  
*Can infect both immunocompetent and immunocompromised hosts
*M. marinum is generally not found in chlorinated swimming pools<ref>Slany M et al. Mycobacterium marinum infections in humans and tracing of its possible environmental sources. Can J Microbiol.  2012. 58(1): 39-44</ref> 
===Risk Factors===
*Aquarium workers and enthusiasts
*Swimming
*Handling of contaminated water

==Clinical Features==
[[File:Fish_Tank_Granuloma_picture_1.jpg|thumb|Fish tank granuloma.  <ref>Ryan, J and Bryant G.  "Fish tank granuloma - a frequently misdiagnosed infection of the upper limb." J Accid Emerg Med. 1997 Nov; 14(6): 398–400.</ref>]]
[[File:Fish_tank_granuloma_4.png|thumb|Fish tank granuloma spreading via lymphatic channels.]]
*Solitary to multiple superficial red [[rash|nodules]] or plaques in exposed areas
**Lesions on the hands and fingers if works with aquariums, or the knees and elbows in swimmers
*Ascending [[lymphangitis]] that resembles [[sporotrichosis]]

==Differential Diagnosis==
{{SSTI DDX}}

==Evaluation==
*Clinical diagnosis in ED
*Can be aided by histopathology
*If there is an affected joint it is important to evaluate for a [[septic arthritis]]
*If there are draining wounds consider imaging and evaluate for [[osteomyelitis]]

==Management==
#Long-term antibiotic therapy (2-18 weeks)
#*Monotherapy with [[doxycycline]], [[clarithromycin]], [[bactrim]], or [[minocycline]]<ref>Petrini, B; "Mycobacterium Marinum: ubiquitous Agent of Waterborne Granulomatous Skin Infections."  European Journal of Clinical Microbiology and Infectious Diseases.  October 2006, Volume 25, Issue 10, pp 609-613</ref><ref>Rallis, E; Koumantaki-Mathioudaki, E; "Treatment of Mycobacterium Marinum Cutaneous Infections." Expert Opinion on Pharmacotherapy.  Volume 8, Issue 17, 2007</ref>
#*Secondary to drug high levels of drug resistance, may require dual drug therapy 
#Warm compresses (bacterium is heat-sensitive)

==Disposition==
*Unless the patient has evidence of sepsis, severe pain, or has other severe complicating medical problems, outpatient treatment is acceptable.
==Clinical Course==
*M marinum infection may result in non-healing ulcers or a septic arthritis. 
*Aggressive or long standing .  marinum infection may cause severe osteomyelitis requiring surgical debreedment

==See Also==
*[[Non-culture growing bacteria]]

==External Links==
*[https://a816-health30ssl.nyc.gov/sites/nychan/Lists/AlertUpdateAdvisoryDocuments/Mycobacterium%20marinum%20outbreak.pdf NYC Chinatown M. marinum outbreak]

==References==
<references/>

[[Category:ID]]
[[Category:Dermatology]]