Khadka et al.1414. Khadka DK, Acharya R, Agrawal S. Sporotrichoid lymphocutaneous pattern in a fish-merchant under immunosuppressant medications: clues to differential diagnoses. Clin Case Rep. 2022;10:e6708. |
F/45 |
Nepal |
Corticosteroids, methotrexate, hydroxychloroquine |
Fish handler |
Left hand, forearm and arm |
Lymphocutaneous form erythematous painful nodules with discharge, swelling of the left hand |
Ethambutol plus Clarithromycin plus Doxycycline 8 months |
Cure |
Cascardo et al.1515. Cascardo CA, Hollis AN, Ansah-Addo S, Smith EH, Mervak JE. Cutaneous Mycobacterium marinum infection secondary to well water exposure masquerading as cutaneous Crohn’s disease. JAAD Case Rep. 2022;30:131-3. |
F/41 |
USA |
Infliximab, methotrexate, prednisone (inflammatory polyarthropathy, Crohn’s disease) |
|
Upper back |
Pruritic, tender erythematous papules and pustules |
Clarithromycin plus Ethambutol – ND |
ND |
Li et al.1616. Li L, Li M. Diagnosis of Mycobacterium marinum infection based on photochromogenicity: a case report. Rev Inst Med Trop Sao Paulo. 2022;64:e76. |
F/35 |
China |
|
Lobster pinch |
Right index finger |
Progressive swelling, pus drainage |
Rifampicin plus Clarithromycin 3m plus surgical drainage |
Cure |
Iwata et al.1717. Iwata K, Takai Y, Kitada N, Morishita N, Kiyona H. Mandibular nodule caused by Mycobacterium marinum with false positive interferon-γ release assay: a case report. Intern Med. 2022 In Press. |
F/63 |
Japan |
|
|
Submandibular |
Submandibular nodule |
Clarithromycin plus Ethambutol 4 weeks |
Cure |
Liu et al.1818. Liu J, Yao Q, Cheng W, Ren H, Hu W. Mycobacterium marinum infection on both hands masquerading as ‘eczema’. Am J Med. 2023;136:e5-6. |
F/68 |
China |
|
Wound on left middle finger, cleaning fish from local market |
Both hands |
Painless plaques |
Doxycycline plus Clarithromycin 5 months |
Cure |
Riccardi et al.1919. Riccardi N, Antonello RM, Canetti D, Polidori M. An octopus gift: Mycobacterium marinum multiple skin lesions. Infection. 2022;50:1631-2. |
M/51 |
Italy |
Adalimumab (psoriasis) |
Octopus fisherman, skin puncture while fishing |
Left hand and wrist |
Reddened ulcerated lesion |
Clarithromycin, plus Rifampicin plus Ethambutol 6–9 months |
Cure |
Seidel et al.2020. Seidel A, Nunes DH, Fernandes C, Funchal GG. Skin infection by Mycobacterium marinum: diagnostic and therapeutic challenge. An Bras Dermatol. 2022;97:366-8. |
M/36 |
Brazil |
|
Fishing, trauma with a perforating-cutting tool |
Left hand, especially the fifth finger |
Papule and exudation, progression to an erythematous-verrucous plaque with nodules and crusts, evident atrophy of the fifth finger |
Clarithromycin plus Doxycycline plus Rifampicin |
Cure |
Patel et al.2121. Patel PM, Camps N, Rivera CI, Tuda C, VanOstran G. Mycobacterium marinum infection and interferon-gamma release assays cross-reactivity: a case report. Cureus. 2022;14:e21420. |
M/61 |
USA |
Adalimumab (psoriatic arthritis) |
|
Right forearm |
Small blister-like lesion which upon removal/resection became ulcerative |
Azithromycin (disc. diarrhea) plus Rifampin, then Ethambutol plus Rifampin (disc. resistance), then Ethambutol plus Rifabutin 5 months |
Cure |
Xing et al.2222. Xing F, Lo SK, Ma Y, Ip JD, Chan WM, Zhou M, et al. Rapid diagnosis of Mycobacterium marinum infection by next-generation sequencing: a case report. Front Med (Lausanne). 2022;9:824122. |
M/38 |
China |
|
Owner of a seafood market, fish bite |
Right middle finger, right hand and elbow |
Lymphocutaneous form poorly healed primary wound on the right middle finger, secondary ulcerated mass on right hand, subcutaneous nodule at the right elbow and supratrochlear lymph nodes |
Rifampin plus Minocycline plus Clarithromycin 9 months |
Cure |
Vanhooteghem et al.2323. Vanhooteghem O, Theate I, De Schaetzen V. Periungual Mycobacterium marinum infection following a fish manicure. Skin Appendage Disord. 2021;7:393-6. |
M/41 |
Belgium |
|
Fish manicure-Thailand vacation |
Left thumb |
Hardened, rough, brownish erythematous periungual plaque |
Doxycycline 4 months |
Cure |
Trčko et al.2424. Trčko K, Plaznik J, Miljković J. Mycobacterium marinum hand infection masquerading as tinea manuum: a case report and literature review. Acta Dermatovenerol Alp Pannonica Adriat. 2021;30:91-3. |
M/37 |
Slovenia |
|
Aquarium owner (tropical fish, exotic snakes, lizards) |
Right hand |
Small warty papule progressed to erythematous scaling plaque on the fourth finger, after a few months a new lesion appeared on the back of his hand and the extensor side of the right wrist. |
Rifampicin plus Clarithromycin 6 months |
Cure |
Wenlong et al.2525. Wenlong H, Qiunan Y, Wenhao C, Yumo L, Tingting Z, Hong R. The combination of photodynamic therapy and fractional CO2 laser for Mycobacterium marinum infection. Photodiagnosis Photodyn Ther. 2021;35:102391. |
M/18 |
China |
|
Chef |
Left hand |
Plaques and nodules |
Photodynamic therapy combined with fractional CO2 laser ablation |
Cure |
Wenlong et al.2525. Wenlong H, Qiunan Y, Wenhao C, Yumo L, Tingting Z, Hong R. The combination of photodynamic therapy and fractional CO2 laser for Mycobacterium marinum infection. Photodiagnosis Photodyn Ther. 2021;35:102391. |
F/70 |
China |
|
Stabbed by a fish |
Right arm |
Painful ulcer on her right forearm |
Photodynamic therapy combined with fractional CO2 laser ablation |
Cure |
Patel et al.2626. Patel AA, Akusoba CN, Yetmar ZA, Tabaja H, Schuetz AN, Camilleri MJ, et al. Mycobacterium marinum following a knife injury. IDCases. 2021;24:e01102. |
F/61 |
USA |
Sjögren’s syndrome, chronic left upper extremity edema (breast cancer – mastectomy, lymphadenectomy, chemotherapy) |
Knife injury to her left thumb while cutting fish |
Left arm |
Lymphocutaneous form pustule at the primary site, additional nodular lesions ascended up her arm to the level of her elbow with associated erythema and drainage |
Clarithromycin plus Ethambutol plus Rifampin. Plan for surgical debridement (due to slow improvement at follow-up) |
Slow improvement |
Su et al.2727. Su Q, Wang F. Painful nodules on the arms. N Engl J Med. 2021;384:e41. |
F/63 |
China |
|
Cut injuries on her hands while cleaning fish |
Both arms |
Painful pink nodules and ulcerations with hemorrhagic crust on both arms |
Moxifloxacin plus Rifampin plus Clarithromycin 6 months |
Cure |
Rathish et al.2828. Rathish B, Mohammed SM, Ullal K, Hassan S, Wilson A. Tropical aquatic skin and soft tissue infections: a series of three cases. Cureus. 2021;13:e13170. |
F/30 |
India |
|
Cut injury to the right wrist while cleaning a fishbowl |
Right forearm |
Lymphocutaneous form multiple nodules with a large nodule that had formed an abscess |
Rifampicin plus Clarithromycin – ND |
Cure |
Costescu Strachinaru et al.2929. Costescu Strachinaru DI, Vanbrabant P, Stinga P, Strachinaru M, Soentjens P. Diagnosis of Mycobacterium marinum Infection with sporotrichoid pattern. Acta Derm Venereol. 2021;101:adv00414. |
F/60 |
Belgium |
|
Owner of a tropical fish tank. Injured by a plant thorn while gardening |
Right arm |
Lymphocutaneous form nodular lesions |
Clarithromycin 14 months |
Cure |
Rida et al.3030. Rida MA, Bardawil T, Ibrahim D. First reported Mycobacterium Marinum infection case in a patient with psoriatic arthritis maintained on Golimumab. Arch Rheumatol. 2020;35: 454-5. |
F/53 |
Lebanon |
Golimumab |
Exposure to fresh fish |
Right hand |
Non-resolving indurated plaque over the base of the right fifth digit right hand |
Clarithromycin plus Doxycycline – ND |
Cure |
Tuan et al.3131. Tuan J, Spichler-Moffarah A, Ogbuagu O. Mycobacterium marinum: nodular hand lesions after a fishing expedition. BMJ Case Rep. 2020;13:e238835. |
M/46 |
USA |
|
Fishing expedition, finger injury and wound exposure to shellfish |
Left hand |
Hyperkeratotic plaques without erythema |
Rifampin plus Clarithromycin plus Ethambutol 4 months |
Cure |
Briand et al.3232. Briand C, Gaudart A, Demonchy D, Hubiche T. Subacute multifocal abscesses related to a Mycobacterium marinum infection in a child. J Pediatr. 2021;230:255-6. |
M/7 |
France |
|
Played in a pond a few weeks before the abscesses |
Both hands and right arm |
Lymphocutaneous form multiple inflammatory cutaneous lesions on both hands and suppurative adenopathy of the right arm |
Clarithromycin 1 month |
Cure |
Bezerra et al.3333. Bezerra GH, Honório ML, Costa VL, Vechi HT, Alves MM, Britto MH, et al. Mycobacterium marinum infection simulating chromomycosis: a case report. Rev Inst Med Trop Sao Paulo. 2020;62:e95. |
M/52 |
Brazil |
|
Bathing in ponds, fishing activities and handling fish, trauma caused by a cactus thorn |
Right lower limb |
Chronic and extensive cutaneous infection Dyschromic atrophic center plate and verrucous borders with hematic crusts |
Ethambutol plus Rifampicin plus TMP-SXT 6 months leaving a dystrophic atrophic plaque |
Cure |
Furuichi et al.3434. Furuichi Y, Ito Y, Tanese K, Mukai M, Uwamino Y, Hasegawa N, et al. Two case reports of Mycobacterium marinum infection with psoriatic arthritis treated by tumor necrosis factor-α inhibitors. J Dermatol. 2021;48:e106-7. |
M/49 |
Japan |
Infliximab (psoriatic arthritis) |
Caring for tropical fish |
Right arm |
Lymphocutaneous form indurated erythema appeared on the dorsal surface of the third digit of the right hand, followed by painful subcutaneous nodules that spread along the lymphatic vessels on the right arm |
Infliximab infusion was discontinued. Moxifloxacin plus Doxycycline plus TMP-SXT 4 months. Infliximab was restarted due to arthritis recurrence within the last 3 months |
Cure |
Furuichi et al.3434. Furuichi Y, Ito Y, Tanese K, Mukai M, Uwamino Y, Hasegawa N, et al. Two case reports of Mycobacterium marinum infection with psoriatic arthritis treated by tumor necrosis factor-α inhibitors. J Dermatol. 2021;48:e106-7. |
M/58 |
Japan |
Adalimumab, methotrexate (psoriatic arthritis) |
Caring for tropical fish |
Right arm |
Lymphocutaneous form erosive erythema on the dorsal surface of the third digit of the right hand and subcutaneous nodules along the lymphatic vessels of the right arm |
Adalimumab was discontinued. Clarithromycin plus Ethambutol plus Doxycycline 5 months, Brodalumab was administered because of arthritis recurrence |
Cure |
Zimmerlich et al.3535. Zimmerlich S, Eder IB, Simon JC, Kunz M. Mycobacterium marinum infection in an immunocompromised patient with infliximab. Eur J Dermatol. 2020;30:436-7. |
M/48 |
Germany |
Infliximab (ulcerative colitis) |
Small wound on his right ring finger – cleaning his two aquariums without gloves |
Right arm |
Lymphocutaneous form, lesion on the nailfold of the right ring finger and multiple painless skin lesions on his right upper extremity |
Clarithromycin plus Ethambutol plus Rifampicin 12 months plus Percutaneous abscess drainage. Then Clarithromycin plus Rifampicin 14 months |
Cure |
Nachimuthu et al.3636. Nachimuthu N, Ganesh SY. Diagnosis of Mycobacterium marinum infection based on seroconversion of QuantiFERON-TB Gold Test. Cureus. 2020;12:e9208. |
F/53 |
USA |
Golimumab (rheumatoid arthritis), diabetes |
Cleaning her fish tank with bare hands, use of lancets for checking blood glucose, injuries from rose thorns |
Left arm |
Lymphocutaneous form tender nodules with surrounding redness on her left index finger and forearm. |
Minocycline plus Clarithromycin 9 months |
Cure |
Berman et al.3737. Berman HS, Thomas L, Beynet D, Gates G, Shi V, Hsiao J. Fish tank granuloma during tumor necrosis factor-alpha inhibitor treatment: a case report and literature review. Dermatol Ther. 2020;33:e14058. |
M/70 |
USA |
Golimumab (ulcerative colitis) |
Cleaning his fish tank |
Left hand, arm |
Lymphocutaneous form, single erythematous indurated plaque with a central ulcer on his left hand and painful nodules on his left arm |
Minocycline 1 week, then Rifampin plus Minocycline (given his immunomodulatory state) 10 weeks |
Cure |
Bachiyska et al.3838. Bachiyska E, Atanasova Y, Baykova A, Yordanova S, Todorova Y. First etiologically confirmed cases of Mycobacterium marinum infection in Bulgaria. Folia Med (Plovdiv). 2020;62:398-402. |
F/66 |
Bulgaria |
|
Hand injury, cleaning an ornamental tropical fish aquarium without using protective gloves. |
Right arm |
Lymphocutaneous form small red-violet papules on right hand and forearm, some progressed to pustules and ulcers, in straight line proximally |
Rifampicin plus Ethambutol, after 2 months disc. joint pain, candidiasis, diarrhea, intestinal pain – continued with symptomatic therapy, lesions slowly improved after 8 months |
Cure |
Bachiyska et al.3838. Bachiyska E, Atanasova Y, Baykova A, Yordanova S, Todorova Y. First etiologically confirmed cases of Mycobacterium marinum infection in Bulgaria. Folia Med (Plovdiv). 2020;62:398-402. |
M/50 |
Bulgaria |
|
Fisher and diver, stab wound on the right hand little finger by a fish fin |
Right hand |
Lesions on the little finger and the thumb, progression to deep tissue infection of wrist |
Rifampicin plus Ethambutol for 1 month, plus Clarithromycin for the next 6 months |
Cure |
Peña Merino et al.3939. Peña Merino L, Mendieta-Eckert M, Méndez Maestro I, Gardeazabal García J. Mycobacterium marinum infection in a woman taking adalimumab. Actas Dermosifiliogr (Engl Ed). 2020;111:525-6. |
F/54 |
Spain |
Adalimumab (rheumatoid arthritis) |
Cut on the finger while preparing fish in her workplace. |
Left hand |
Multiple erythematous-violaceous papules on the left hand and wrist |
Minocycline 2 months; despite marked improvement, some active lesions persisted; treatment was switched to Clarithromycin |
Cure |
Park et al.4040. Park JB, Seong SH, Kwon DI, Jang JY, Suh KS, Jang MS. Mycobacterium marinum infection spreading in a “birds in flocks” pattern: all caseating granuloma is not tuberculosis. Acta Derm Venereol. 2020;100:adv00200. |
F/74 |
Korea |
Local steroid injection in the elbow to treat arthritis |
Trimming oysters |
Left arm, trunk |
Diffuse tender erythematous and yellow cellulitis-like patches on her left arm, discrete papules on the left trunk |
Doxycycline plus Clarithromycin plus Rifampin 3 months, moderate improvement – lost to follow-up |
Moderate improvement –lost to follow-up. |
Bollam et al.4141. Bollam R, Phan T. Mycobacterium marinum infection of the hand presenting as a nodular skin lesion. J Clin Tuberc Other Mycobact Dis. 2020;20:100166. |
M/33 |
USA |
|
Landscape work, in which he might have a skin injury, owner of fish tank (without fish) |
Right hand |
Nodular skin lesion on the right index finger |
Incision and drainage of the nodule with excision of a deep mass, advised to follow-up outpatient for further care |
ND |
Chokevittaya et al.4242. Chokevittaya P, Apisarnthanarak A, Chansirikarnjana S, Boonyasirikool C, Kintarak J, Weber DJ. Photo quiz: a 53-year-old Thai man with progressive swelling of the left index finger. J Clin Microbiol. 2020;58:e02058-18. |
M/53 |
Thailand |
|
Ant bite while gardening near a pond, hobbies: gardening, decorating corals at his home. |
Left hand |
Progressive swelling of his left index finger for 4 months, abscess formation |
Rifampin plus Clarithromycin plus Streptomycin plus multiple surgical debridements |
Cure |
Drakou et al.4343. Drakou A, Psifis M, Mitrou A, Zygoggianis K, Argyropoulou O. Unresolved swelling of the hand: think of Mycobacterium marinum infection. Trauma Case Rep. 2020;26:100283. |
M/48 |
Greece |
Infliximab (ankylosing spondylitis), oral steroid treatment |
Puncture on his left index finger while working at an underwater ship repair |
Left hand and forearm |
Lymphocutaneous form painful swelling over the affected area, subcutaneous abscesses |
Anti-TNFa was discontinued, surgical intervention, Clarithromycin plus Ethambutol plus Rifampicin |
Cure |
Conforti et al.4444. Conforti C, Zalaudek I, Vichi S, Di Meo N. Dermoscopy of Mycobacterium marinum skin infection: a challenging diagnosis. Acta Dermatovenerol Croat. 2019;27:278-9. |
M/66 |
Italy |
|
Aquarium owner |
Left hand |
Two purplish painful nodules on the left hand |
Clarithromycin 4 weeks |
Cure |
Assiri et al.4545. Assiri A, Euvrard S, Kanitakis J. Cutaneous Mycobacterium Marinum infection (fish tank granuloma) in a renal transplant recipient: case report and literature review. Cureus. 2019;11:e6013. |
M/72 |
France |
Cyclosporin, steroids, mycophenolic acid (kidney transplant patient) |
Minor trauma (cut) while cleaning his fish tank |
Right hand |
Asymptomatic, erythematous, scaly nodule over the proximal interphalangeal joint of the right index finger |
Immunosuppressive treatment was reduced (cyclosporin dosage was lowered), Minocycline 2 months, switched to Doxycycline 3 months |
Cure |
Feng et al.4646. Feng H, Su Y, Fu S, Zhou Y, Xiao R, Wu R, et al. Image gallery: fish tank granuloma on the face with sporotrichoid cervicofacial lymphadenitis and abscesses due to Mycobacterium marinum infection. Br J Dermatol. 2019;180:e180. |
M/53 |
China |
|
Scratch on the nose root by a rusty shrimp cage |
Face, neck |
Lymphocutaneous form erythematous papules and plaques on the nose root, abscesses on the neck and face, cervicofacial lymphadenitis |
Rifampin plus Ethambutol plus Minocycline 3 months |
Cure |
Vemulakonda et al.4747. Vemulakonda LA, Tschen JA. Slow-growing and linearly spreading cutaneous lesion: often misdiagnosed Mycobacterium marinum infection. Cureus. 2019;11:e4154. |
M/69 |
USA |
|
Cleaning an aquarium at home |
Right arm |
Lymphocutaneous form verrucous plaques on the right elbow and ulcerated papulonodules on the right arm |
Rifampin plus Ethambutol, ongoing therapy |
Considerable improvement |
Esteves et al.4848. E steves M, Nogueira A, Azevedo F. A case of cutaneous nodules in a sporotrichoid pattern. Dermatol Online J. 2019;25:12. |
M/65 |
Portugal |
|
Gardening-rose thorn injury to the left thumb. Cleaning an aquarium. |
Left hand and forearm |
Lymphocutaneous form erythematous nodules in a linear distribution along the left hand and forearm. |
Clarithromycin plus Rifampicin 6 months |
Cure |
Bouceiro-Mendes et al.4949. Bouceiro-Mendes R, Ortins-Pina A, Fraga A, Marques T, Viveiros M, Machado D, et al. Mycobacterium marinum lymphocutaneous infection. Dermatol Online J. 2019;25:10. |
M/33 |
Portugal |
|
Minor cut on the finger, cleaning an aquarium of tropical fish without hand protection. |
Right hand and forearm |
Lymphocutaneous form ulcerated nodule on the right fingertip, painful plaques and nodules, some suppurative, on the right hand and forearm |
Clarithromycin plus Ethambutol plus Rifampicin 9 months |
Cure |
Kobayashi et al.5050. Kobayashi T, Ford B, Sekar P. A case of severe cutaneous Mycobacterium marinum infection in a patient with Crohn’s disease on chronic high-dose prednisone. BMJ Case Rep. 2019;12:bcr-2018-228516. |
M/73 |
USA |
Prednisone (Crohn’s Disease) |
Salt and fresh water fish tank that he routinely cleaned and maintained |
Hands, face and trunk |
Several erythematous nodular lesions on bilateral hands and erythematous papules on his chest, abdomen, face and extremities |
TMP-SXT (Nocardia was suspected – rash improved) plus Rifabutin, ongoing therapy |
Improvement |
Koushk-Jalali et al.5151. Koushk-Jalali B, Freitag AP, Tigges C, Oellig F, Hillemann D, Kreuter A. Sporotrichoid fish tank granuloma. QJM. 2019;112:147. |
M/66 |
Germany |
Myelodysplastic syndrome (treated with subcutaneous erythropoietin injections) |
Aquarium hobbyist |
Right hand and arm |
Lymphocutaneous form, nodules and plaques that firstly occurred on the right index finger and spread to the fore- and upper arm along the lymphatic vessels |
Rifampicin plus Ethambutol was initiated, with almost complete clearance of the skin lesions within 8 weeks, ongoing therapy |
Cure |
Sahuquillo-Torralba et al.5252. Sahuquillo-Torralba A, Calle-Andrino A, Gil-Brusola A, Évole-Buselli M. Granulomatous plaque of the right knee in a 10-year-old boy. Enferm Infecc Microbiol Clin (Engl Ed). 2019;37:58-9. |
M/10 |
Spain |
|
Skin abrasion, bathing with a tortoise, swimming in pools |
Right knee |
Erythematous plaque |
Clarithromycin 5 months |
Cure |