Kutane Infektionen durch Mycobacterium marinum

Abstract

Mycobacterium marinum belongs to the non-tuberculous or "atypical" mycobacteria. The reservoirs for these ubiquitous and slowly growing bacteria are both fresh water and salt water. In particular, aquaria should be considered as important source of hobby-related infections especially of fingers, hands and forearms. Affected are both immunosuppressed patients and persons with an intact immune system. Distinctive are erythematous plaques and nodules with tendency for hyperkeratosis, crusting, and superficial ulcerations, sometimes as sporotrichoid lymphocutaneous infection. The histology shows non-caseation granulomas containing epithelioid cells and Langhans giant cells. Using the Ziehl Neelsen staining, typical acid-fast rods are not always detectable. The molecular biological detection of mycobacterial DNA using polymerase chain reaction represents the standard method of diagnosis. Cryotherapy is frequently used as first treatment. For the often long-term tuberculostatic therapy, rifampicin, ethambutol, and clarithromycin are the most used agents.

Mycobacterium marinum infection initially diagnosed as metastatic Crohn's disease

“…2 The negative result in our patient could also be due to the immunosuppressive treatment, which the patient was currently receiving. Although the prevalence of Mycobacterium marinum is very low (the estimated number in the US is about 0.27 cases per million inhabitants 4 ), it is important to consider the entity especially in immunosuppressed patients with a therapy-resistant pyoderma and a granulomatous inflammation. According to our knowledge, this is the first case report in which the immunosuppressive treatment was continued during antibiotic therapy for Mycobacterium marinum infection.…”

“…1 There are six cases of TC mimicking dissecting cellulitis in the literature. [2][3][4][5][6] We present three additional cases to discuss diagnostic challenges and describe the role of trichoscopy in diagnosis.…”

Diagnostik und Therapie von Mycobacterium‐marinum‐Infektionen: Ergebnisse einer retrospektiven monozentrischen Studie

“…Gelegentlich treten pustulöse, knotig-ulzerative, granulomatöse oder verruköse Plaques auf. Der Befall tieferer Strukturen kann zu Sehnenscheidenentzündungen, Osteomyelitis, Arthritis oder Bursitis führen [5,9].…”

Haut- und Weichgewebe-Infektionen durch nicht-tuberkulöse Mykobakterien: Ätiologie, Epidemiologie, Pathogenese, Klinik, Diagnostik, differenzialdiagnostische Aspekte und Empfehlungen für die Therapie

“…Oberflächliche, lokalisierte Infektionen können durchaus auf eine Monotherapie, z. B. mit Clarithromycin, ansprechen [73]. Bei seit längerer Zeit bestehenden und ausgedehnteren Infektionen sind Antibiotika-Kombinationen zu bevorzugen.…”