C-195. Mycobacterium marinum Skin Infections: A Case Series from a Gulf Coast University Healthcare System and Review of the Literature

K. C. Whithaus, J. E. Carter;
Univ. of South Alabama, Mobile, AL.

Mycobacterium marinum is an atypical mycobacterium and a rare cause of human skin infections. Typically, infections occur after soft tissue trauma with exposure to fresh or salt water. While there are occasional case reports in the medical literature, there are no recent case series in the United States and no series which involve the Gulf Coast, a major center for the fishing and tourism industries. Review of the medical data base from our University healthcare system on the Gulf Coast revealed four culture-confirmed cases of M. marinum skin infection and an additional five cases of skin lesions which were not culture-confirmed but were clinically and histologically compatible with M. marinum infection. The four culture-confirmed cases all occurred in males with an age range from 37 to 72 years. All four cases involved the distal right upper extremity. The additional five cases consisted of surgical biopsy specimens from patients with a clinical history of water-related trauma and a histologic picture of granulomatous inflammation compatible with M. marinum infection. These cases occurred in 2 female and 3 male patients. Of these cases, 3 involved the upper extremity while the remaining two involved the left lower extremity. Of the 9 total cases of culture-confirmed and histologically compatible M. marinum infection, we found that 78% (7 of 9) of the cases occurred in males and 67% (6 of 9) involved the distal right upper extremity. The majority of these cases occurred during the Spring months (56%), while none of the cases occurred during the Fall. We review the current literature and summarize the recent guidelines for treatment and management of these unusual waterborne infections.