Infezione cutanea da Mycobacterium marinum. Caso clinico

A 51-year-old man, affected by dilated cardiomyopathy, awaiting transplant, was observed at our Dermatology Department in April 2000. Nine months earlier he had noticed the presence of nodular lesions and crusty ulcers and abscesses on the dorsal surface of his left hand. The lesions presented some days after he had cleaned his aquarium. A skin biopsy was performed and histological examination revealed an intense granulomatous epitheloid reaction surrounding wide areas of necrosis. Although negative for Ziehl-Nielsen staining, the sample seemed to suggest infection with mycobacteria. Cultural examination for yeasts was negative, while Mycobacterium marinum was isolated from mycobacteria culture. Antibiogram proved to be sensitive to amikacin, clarithromicin and rifampin. The patient was treated with clarithromicin 500 mg pro die for 15 days, with complete resolution in about 45 days.