Deep infection with Mycobacterium marinum: successful treatment of a frequently misdiagnosed disease

BMJ Case Rep. 2019 Aug 28;12(8):e229663. doi: 10.1136/bcr-2019-229663.

Abstract

We report a rare yet typical presentation of a severe infection with Mycobacterium marinum that affected the deep structure of the hand and wrist of a 43-old fish breeder. A combination therapy of surgical debridement and antibiotic treatment with clarithromycin and ethambutol for 6 months led to a total resolution of the symptoms. Intensive rehabilitation completely restored the function of the hand.

Keywords: bone and joint infections; drugs: infectious diseases; infections; radiology.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Clarithromycin / administration & dosage
  • Clarithromycin / therapeutic use
  • Combined Modality Therapy / methods
  • Debridement / methods
  • Diagnostic Errors
  • Ethambutol / administration & dosage
  • Ethambutol / therapeutic use
  • Female
  • Hand / diagnostic imaging
  • Hand / pathology*
  • Hand Injuries / complications
  • Hand Injuries / microbiology*
  • Humans
  • Magnetic Resonance Imaging / methods
  • Mycobacterium Infections, Nontuberculous / diagnosis*
  • Mycobacterium Infections, Nontuberculous / microbiology
  • Mycobacterium Infections, Nontuberculous / therapy
  • Mycobacterium marinum / isolation & purification*
  • Tenosynovitis / diagnostic imaging
  • Tenosynovitis / pathology
  • Treatment Outcome
  • Wrist / diagnostic imaging
  • Wrist / pathology*

Substances

  • Anti-Bacterial Agents
  • Ethambutol
  • Clarithromycin

Supplementary concepts

  • Infection with Mycobacterium marinum