Mycobacterium marinum infections

Mycobacterium marinum infections (Fish-Fancier's finger or Swimming pool granuloma) is a common nontuberculous mycobacterial (NTM) infection. It presents as a papule usually on the upper extremity. The papule ulcerates and scars. Ascending nodular lymphangitis is observed in some patients.

CASES/YEAR
100 (US); 2,000 (Global)
CATEGORY
Sapronoses
AGENT TYPE
Bacteria
OTHER NAMES
Fish-Fancier's finger; Swimming pool granuloma;
ACUITY
Subacute/Chronic
INCUBATION
Typically 2-4 weeks, but can be longer; [ABX Guide]
INITIAL SYMPTOMS
Papule usually on the upper extremity; Papule ulcerates and scar tissue develops; Ascending nodular lymphangitis is observed in some patients; [ATS/IDSA Statement: Nontuberculous Mycobacterial Diseases]
PRECAUTIONS
COMMENTS
Mycobacterium marinum is a common nontuberculous mycobacterial (NTM) infection. It is an occupational hazard for aquarium and fish tank attendants and swimming pool cleaners. In some cases, the infection may resemble sporotrichosis with ulcerating papules or nodules that ascend the arm or leg following regional lymphatic vessels. In some cases, deep infections cause tenosynovitis. Patients with AIDS are at increased risk for this infection. [LaDou, p. 288; Guerrant, p. 245-6] M. marinum is one of the common causes of nodular lymphangitis in the USA. Other NTM also cause nodular lymphangitis. [Am Fam Physician 2001;63:326-32] The skin lesion is a chronic nodule, ulcer, or warty growth at the site of a previous abrasion, commonly at the elbow or knee. [PPID, p. 1327] Osteomyelitis has been reported. [ID, p. 2189] Deep infections can involve tendon, joint, and bone. [ABX Guide: Mycobacterium marinum]
DIAGNOSTIC
Clinical; Biopsy with histological examination and culture;
SCOPE
Global
SIGNS & SYMPTOMS
  • S lymphangitis
  • S nodular lymphangitis
  • S papules or plaques
  • S pustule
  • S skin or subcutaneous nodule
  • S ulcer of skin
  • S warty growth of the skin
  • *arthritis
  • *osteomyelitis
ANTIMICROBIC

Yes

VACCINE

No

ENTRY
Skin or Mucous Membranes (Includes Conjunctiva)
RESERVOIR
Fish and Shellfish
RISK FACTORS
  • AIDS patients
  • Clean pools or aquariums
  • Touch infected fish or shellfish
DRUG LINK
Merck Manual: Other Mycobacterial Infections Resembling Tuberculosis
REFERENCES FOR CASES/YEAR
1. (US) No data found; Assume same cases/yr as Vibrio vulnificus infection;
2. (Global) No data found; Assume same rate as Vibrio vulnificus infection;