OVERVIEW
Overview of Mycobacterium marinum infection
Mycobacterium marinum infection is a limited skin disease caused by skin invasion by Mycobacterium marinum during contact with seawater or freshwater.
Is it covered by Medicare?
Yes, it is covered by Medicare.
Department
Infection, Dermatology
Clinical symptoms
Papules, nodules, superficial ulcers, tenderness to percussion, etc.
Harm
A few old lesions may be wart-like or form a scar, which affects the appearance.
Examination
Physical examination, bacterial culture, pathologic examination, antacid staining, nucleic acid test, etc.
Diagnosis
Diagnosis is made on the basis of history, rash and bacterial culture, pathologic examination, antacid staining, and nucleic acid test.
Treatment principle
There is no specific treatment at present. Antibacterial treatment is commonly used, which can be supplemented with physical therapy.
Curability
The skin lesions tend to heal naturally within a few months to 3 years.
Dietary advice
Nutritious and light diet.
Causes
Epidemiology
Most often seen in fishermen or those who have contact with lake, river or sea water, swimming pools, fish ponds.
Etiology
Caused by Mycobacterium marinum infection.
Symptoms and Diagnosis
Typical symptoms
Skin lesions occur on elbows, knees, hands and feet, fingers and toes, ankles, calves and other limbs vulnerable to trauma, elbow lesions are the most common, lesions are small reddish-brown papules, slow-growing, red or purple nodules can be formed, not accompanied by self-conscious pain, but there is pain on percussion, and a very small number of them can be broken down to form superficial ulcers. The lesions are often solitary and arranged centripetally along the lymphatic vessels.
Diagnostic basis
1. History of exposure to lake, river or sea water, swimming pools, fish ponds. 2. Clinical manifestations: lesions are often solitary, with reddish-brown papules, nodules or plaques appearing at the place of infection, which may break into small superficial ulcers. 3. Adjunctive examinations: antacid staining is positive; bacterial cultures may detect Mycobacterium marinum; nucleic acid test is positive; pathologic examination reveals nodular-like structures. 4. Early lesions show inflammatory infiltration of lymphocytes, neutrophils and histiocytes in the dermis, and there may be hyperkeratosis of the epidermis and a thick stratum spinosum. Older lesions show intradermal granulomatous reaction, which may invade the subcutaneous tissue and form typical tuberculous nodules without caseous necrosis; antacid bacilli can sometimes be found in the histiocytes, which are longer and coarser than Mycobacterium tuberculosis, and are commonly cross-arranged.
Treatment
Treatment guidelines
Aggressive antimicrobial therapy, can be supplemented with physical therapy, etc.
Drug therapy
Commonly used drugs such as minocycline, ethambutol, isoniazid, rifampicin, compound sulfamethoxazole. Anti-tuberculosis drugs are ineffective.
Other treatments
Local treatments include hyperthermia, infrared irradiation, warm and wet compresses, cryotherapy, etc. Freeze-dried BCG vaccine and mycobacterial vaccine therapy are also effective.
Prognosis
Most of the lesions heal naturally within a few months to 3 years, and a few lesions last for a longer period of time.
Nursing care
Daily care
1. Environment and rest keep the environment quiet and clean, ventilation every day; life should be regular, ensure enough sleep, avoid excessive fatigue. 2. Skin care keep the local skin clean and dry, wash the skin with lukewarm water every day, disable soap and water scrubbing. 3. Clothes and blankets should be kept clean, smooth, dry and soft, and changed frequently; avoid scratching the skin.3. Psychological care: relax, reduce psychological pressure, keep open-minded, avoid stress.4. Medication guidance: Follow the doctor’s instructions to take medication, and don’t increase, decrease or stop the medication on your own.
Dietary care
Nutritious and light diet.