Background: Mycobacterium marinum is a cause of granulomatous skin and soft tissue infections normally associated with injury from marine exposure.† Most treatment regimens are based on nontuberculous mycobacterial guidelines and the susceptibilities of the individual isolates.† We describe the experience of physicians at the Medical University of South Carolina (MUSC) with M. marinum infections.
Methods: A retrospective chart analysis was conducted on patients with positive M. marinum cultures from 1/1/06 to 8/1/14 at MUSC.† Patient characteristics, culture data, pathology and treatment were recorded.†
Results: Twenty patients at MUSC had positive cultures for M. marinum between 1/1/06 and 8/1/14.† All infections occurred in the upper extremities of male patients, 95% of whom were Caucasian.† Three patients had known exposure to aquariums. For 14 patients with known injuries, time from injury to presentation ranged from 2 weeks to 11 months.† Five patients had a sporotricoid spread (distinct nodules progressing up extremity), all of whom had initial infections in their hands or arms.† From 14 pathology samples, 10 had auramine-rhodamine stains (all negative), and 10 had granulomas noted.† Eighteen patients had negative culture smears.† Susceptibilities were performed on 5 isolates, with no common resistances. Orthopedic hand surgery was route of entry to MUSC care in the majority of cases (15/20). Seventeen patients had surgery as part of their treatment.† Duration of therapy ranged from 2 to 6 months.† Four patients had residual impairment post-infection resolution, and another patient had recurrence after directed therapy.††
Conclusion: Mycobacterium marinum infections were more common in Caucasian males in our study (95%) compared to our county demographics (67.4%).† Males and marine exposure were more common, consistent with other studies.† Smears and pathology were commonly negative. Most patients had surgery as part of their treatment.† Duration and antibiotic regimens varied between providers, but overall outcomes were good.
L. Richey, None