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Fishy story: paradoxical reaction associated with Mycobacterium marinum
  1. Alexander M Tatara1,2,3,
  2. Nesli Basgoz1,2 and
  3. Sandra B Nelson1,2
  1. 1 Harvard Medical School, Boston, Massachusetts, USA
  2. 2 Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA
  3. 3 Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
  1. Correspondence to Dr Alexander M Tatara; alexander.tatara{at}utsouthwestern.edu

Abstract

Paradoxical reactions occur when an infection has acute worsening in response to antibiotic therapy. Here, we describe a patient with chronic cutaneous ulcerative lymphangitis that acutely worsened following initiation of antibiotic therapy. The infection was caused by Mycobacterium marinum, a species which has not previously been associated with paradoxical reaction in immunocompetent persons. In this case report, we describe our patient’s diagnosis and management, review the management of Mycobacterium marinum infection, and discuss paradoxical reactions in mycobacterial disease.

  • Infectious diseases
  • Immunology
  • TB and other respiratory infections
  • Dermatology

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Footnotes

  • X @AMTatara

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: AT, NB and SBN. The following authors gave final approval of the manuscript: AT, NB and SBN.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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