minocycline and Sporotrichosis

Mycobacterium marinum is an atypical mycobacterium found worldwide and associated with swimming pools and aquariums. Infections typically present with subcutaneous nodules and lymphangitis.. A 61-year-old female presented with a two-month history of subcutaneous nodules. The patient had a significant recent history that included rose gardening and cleaning her aquarium at home. Biopsy for histology and tissue culture proved the presence of infection with Mycobacterium marinum and the patient was treated with minocycline. The nodules eventually healed and no new lesions appeared after initiation of treatment.. Mycobacterium marinum is one of many entities that must be considered in a patient with ascending nodules along the lymphatic drainage of an extremity.

Topics: Animals; Anti-Bacterial Agents; Clarithromycin; Diagnosis, Differential; Doxycycline; Drug Therapy, Combination; Ethambutol; Female; Fishes; Forearm; Gardening; Hand Dermatoses; Hobbies; Humans; Middle Aged; Minocycline; Mycobacterium Infections, Nontuberculous; Mycobacterium marinum; Skin Diseases, Bacterial; Sporotrichosis; Water Microbiology

Sporotrichoid forms of atypical mycobacterial infections usually do not show a tendency to spontaneous healing. The therapy of choice in such cases is systemic antibiotics. We report three cases of sporotrichoid atypical mycobacterial infections of the skin which healed completely under long-term monotherapy with modern antibiotics (levofloxacin, clarithromycin, minocycline). We recommend confirming the diagnosis by means of culture, followed by monotherapy with low side-effect antibiotics, based on sensitivity studies. If pathogen proof is obtained by PCR, antibiotic therapy should be based on the known sensitivity of the pathogen in question.

Topics: Adult; Biopsy; Clarithromycin; Diagnosis, Differential; Drug Resistance, Multiple, Bacterial; Female; Forearm; Hand Dermatoses; Humans; Levofloxacin; Lymphadenitis; Male; Middle Aged; Minocycline; Mycobacterium chelonae; Mycobacterium Infections, Nontuberculous; Mycobacterium marinum; Ofloxacin; Skin; Skin Diseases, Bacterial; Sporotrichosis; Treatment Outcome

Atypical mycobacterial infections of the skin present a diagnostic and therapeutic challenge to dermatologists in many instances. We report on a patient who was diagnosed with atypical mycobacteriosis in its rarer, sporotrichoid form. Possible differential diagnoses are discussed. Efficient therapy using minocycline is demonstrated.

Topics: Administration, Oral; Biopsy; Female; Hand Dermatoses; Humans; Middle Aged; Minocycline; Mycobacterium Infections, Nontuberculous; Mycobacterium marinum; Skin; Sporotrichosis

Mycobacterium marinum infections have been reported for over 50 years, mostly in association with trauma in the setting of water exposure.. The differential diagnosis for nodules in a sporotrichoid distribution with simultaneous bursitis is discussed. Mycobacterium marinum treatment regimens for skin and joint involvement are reviewed.. Mycobacterium marinum was identified by skin tissue culture with Lowenstein-Jensen medium at 32 degrees C. Histopathologic findings support mycobacterial infection.. Bursitis and nodules resolved in the first 2 months of a 6-month course of minocycline treatment.. Bursitis is an extremely rare but significant complication of M. marinum.

Topics: Aged; Anti-Bacterial Agents; Bursitis; Diagnosis, Differential; Follow-Up Studies; Humans; Male; Minocycline; Mycobacterium Infections, Nontuberculous; Mycobacterium marinum; Skin Diseases, Bacterial; Sporotrichosis

Topics: Diagnosis, Differential; Humans; Male; Middle Aged; Minocycline; Mycobacterium Infections; Mycobacterium Infections, Nontuberculous; Skin Diseases, Infectious; Sporotrichosis