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Mycobacterium marinum: nodular hand lesions after a fishing expedition
  1. Jessica Tuan,
  2. Anne Spichler-Moffarah and
  3. Onyema Ogbuagu
  1. Department of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut, USA
  1. Correspondence to Dr. Jessica Tuan; Jessica.Tuan{at}


Mycobacterium marinum is a slow-growing, acid-fast bacillus in the category of non-tuberculous mycobacteria which most commonly cause skin and soft tissue infections in patients, particularly those with aquatic exposure. Classically, M. marinum skin and soft tissue infections clinically manifest with formation of nodular or sporotrichoid extremity lesions, or deeper space infections such as tenosynovitis and osteomyelitis. Disseminated disease may occur in immunocompromised hosts. M. marinum is a slow-growing organism that is challenging to culture, as it typically requires 5–14 days (yet may take up to several weeks) with low temperatures of approximately 30°C to yield growth. In terms of treatment, further data are needed to elucidate the optimal regimen and duration for M. marinum infections. Combination therapy with clarithromycin and ethambutol is recommended for treatment of skin and soft tissue infections, with addition of rifampicin for deeper space infections. Surgery may be needed in addition to medical management.

  • infectious diseases
  • dermatology

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  • Contributors JT is the first author of the manuscript. The subsequent author is AS-M. The final author is OO. We have all contributed as authors to this manuscript in terms of planning, conception and design, writing and editing various drafts of the manuscript. The manuscript has been read and approved by all of the authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer-reviewed.