Aquarium-borne Mycobacterium marinum skin infection. Report of 15 cases and review of the literature

Abstract

Mycobacterium marinum is a non-tuberculous photochromogenic mycobacterium, commonly responsible for fish and amphibious infections world-wide. Contagion in humans typically follows minor hand trauma from aquarium keeping and manifests as a granulomatous infection of the skin. Dissemination is rare and almost exclusive to immunosuppressed hosts. 15 cases of M. marinum fish tank related infection are hereby reported. The site of infection was the upper limbs in all cases. 3 patients presented a single papulo-verrucous lesion, while the remaining 12 showed a sporotrichoid clinical pattern. Diagnosis was reached by history and clinical examination and further supported by one or more of the following criteria: histology, culture, acid fast bacilli identification from histologic specimen and PCR. 2 to 3 months minocycline treatment showed efficacy in 13 individuals, another case was treated with rifampicin-isoniazid association, yet another showed spontaneous regression over a 3 month period.

Mycobacteriosis and Infections with Non-tuberculous Mycobacteria in Aquatic Organisms: A Review

“…Mycobacterium spp. can be cultivated at room temperature or at environmental temperature, depending on the species, and take anywhere between 2 to 28 days to form clear colonies [ 75 , 76 ]. For example, M. marinum will grow at 30 °C, while others species such as M. shottsii and M. pseudoshottsii will grow at 23 °C and not well or at all at 30 °C [ 77 ].…”

Zebrafish as a model for zoonotic aquatic pathogens

“…Additionally, infections have been linked to swimming in contaminated aquatic environments (Bonamonte et al, 2013; Wu et al, 2012). These infections can become severe, requiring prolonged multi-antibiotic therapy and/or surgical interventions (Bonamonte et al, 2013; Huang et al, 2012; Wu et al, 2012). In patients being treated with immunosuppressive drugs, these infections can be more prevalent and severe (Ferreira et al, 2012).…”

“…In patients being treated with immunosuppressive drugs, these infections can be more prevalent and severe (Ferreira et al, 2012). Superficial infection can rarely disseminate to bones and joints or cause a pulmonary infection (Bonamonte et al, 2013; Wu et al, 2012). Mycobacteria are also natural pathogens of marine and freshwater fish (see (Gauthier and Rhodes, 2009; Jacobs et al, 2009) for review and citations within).…”

Screening of anti-mycobacterial compounds in a naturally infected zebrafish embryo model

“…M. marinum is a pathogen of ectotherms (fish, amphibians and reptiles) that produces a tuberculosislike disease 9 . M. marinum is a close genetic relative of M. tuberculosis , with which it shares conserved virulence determinants 9 , and has been known to cause granulomatous skin infections in humans 10, 11 . Infection of the tropical zebrafish, Danio rerio , with M. marinum has been used to develop a surrogate in vivo model of TB pathogenesis 12 useful for the rapid screening of potential antimycobacterial compounds 13 .…”